Provider Demographics
NPI:1275503492
Name:QAMAR, JOSEPH MAMMOUN (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:MAMMOUN
Last Name:QAMAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:MAMMOUN
Other - Middle Name:Y
Other - Last Name:ABOU QAMAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:13737 NOEL RD STE 1400
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75240-2004
Mailing Address - Country:US
Mailing Address - Phone:214-217-1911
Mailing Address - Fax:214-217-1912
Practice Address - Street 1:3301 MATLOCK RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76015
Practice Address - Country:US
Practice Address - Phone:817-733-7328
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2019-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM2622207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN177189101Medicaid
TX8G0744Medicare ID - Type UnspecifiedMEDICARE
TN177189101Medicaid