Provider Demographics
NPI:1447231295
Name:MEMON, AMIR A G (MD)
Entity Type:Individual
Prefix:DR
First Name:AMIR
Middle Name:A G
Last Name:MEMON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:12834 WILLOW CENTRE DR STE E
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77066-3047
Mailing Address - Country:US
Mailing Address - Phone:280-580-9100
Mailing Address - Fax:281-580-9577
Practice Address - Street 1:12834 WILLOW CENTRE DR STE E
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77066-3047
Practice Address - Country:US
Practice Address - Phone:280-580-9100
Practice Address - Fax:281-580-9577
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-09
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXK8339207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8J9479Medicare PIN
H02150Medicare UPIN
TX00100QMedicare PIN
TX8J9478Medicare PIN
TX458811Medicare PIN
TX00100QMedicare UPIN