Provider Demographics
NPI:1760489686
Name:ILAHI, OMER A (MD)
Entity Type:Individual
Prefix:DR
First Name:OMER
Middle Name:A
Last Name:ILAHI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6560 FANNIN ST
Mailing Address - Street 2:STE 1016
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2761
Mailing Address - Country:US
Mailing Address - Phone:713-800-1100
Mailing Address - Fax:713-800-1101
Practice Address - Street 1:3711 GARTH RD
Practice Address - Street 2:SUITE E
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77521-3178
Practice Address - Country:US
Practice Address - Phone:281-428-1001
Practice Address - Fax:713-800-1101
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2019-10-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXH7616207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1320533-07Medicaid
TX8553B6Medicare PIN
TXG14062Medicare UPIN
TXTXB115585Medicare PIN