Provider Demographics
NPI:1609571546
Name:SHAILAJA JAMMA MD PA
Entity Type:Organization
Organization Name:SHAILAJA JAMMA MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:SHAILAJA
Authorized Official - Middle Name:
Authorized Official - Last Name:JAMMA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-234-5872
Mailing Address - Street 1:15200 SOUTHWEST FWY STE 310
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-3864
Mailing Address - Country:US
Mailing Address - Phone:713-234-5872
Mailing Address - Fax:713-234-5873
Practice Address - Street 1:15200 SOUTHWEST FWY STE 310
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-1587
Practice Address - Country:US
Practice Address - Phone:713-234-5872
Practice Address - Fax:713-234-5873
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-31
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty