Provider Demographics
NPI:1568433027
Name:ZIAI- JAMALABADI, ELHAM (MD)
Entity Type:Individual
Prefix:DR
First Name:ELHAM
Middle Name:
Last Name:ZIAI- JAMALABADI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ELHAM
Other - Middle Name:
Other - Last Name:ZIAI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1406 REIGER DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75402-7619
Mailing Address - Country:US
Mailing Address - Phone:903-454-7355
Mailing Address - Fax:
Practice Address - Street 1:4211 JOE RAMSEY BLVD E
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:TX
Practice Address - Zip Code:75401-7852
Practice Address - Country:US
Practice Address - Phone:903-408-7700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-31
Last Update Date:2022-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM3439207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXH29502Medicare UPIN