Provider Demographics
NPI:1689781072
Name:AMIN R. JAMAL M.D., P.A.
Entity Type:Organization
Organization Name:AMIN R. JAMAL M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ENDOCRINOLOGIST
Authorized Official - Prefix:MR
Authorized Official - First Name:AMIN
Authorized Official - Middle Name:R
Authorized Official - Last Name:JAMAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD,PA
Authorized Official - Phone:713-270-1800
Mailing Address - Street 1:7777 SOUTHWEST FREEWAY PROF. BLDG. 1
Mailing Address - Street 2:SUTIE 802
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074
Mailing Address - Country:US
Mailing Address - Phone:713-270-1800
Mailing Address - Fax:713-270-1803
Practice Address - Street 1:7777 SOUTHWEST FREEWAY PROF. BLDG. 1
Practice Address - Street 2:SUTIE 802
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074
Practice Address - Country:US
Practice Address - Phone:713-270-1800
Practice Address - Fax:713-270-1803
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-23
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX01440996261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX030806601Medicaid
TX0017EWOtherBLUE CROSS BLUE SHIELD
TX030806601Medicaid
TXH17596Medicare UPIN