Provider Demographics
NPI:1578787768
Name:DR. JAMIL A. MEMON PA
Entity Type:Organization
Organization Name:DR. JAMIL A. MEMON PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JAMIL
Authorized Official - Middle Name:M
Authorized Official - Last Name:MEMON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-316-7966
Mailing Address - Street 1:2003 GREENWOOD OAKS DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77062-2306
Mailing Address - Country:US
Mailing Address - Phone:281-316-7966
Mailing Address - Fax:281-316-7963
Practice Address - Street 1:350 BLOSSOM ST
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4206
Practice Address - Country:US
Practice Address - Phone:281-316-7966
Practice Address - Fax:281-316-7963
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2018-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXH88144Medicare UPIN
TX00X879Medicare PIN