Provider Demographics
NPI:1760496004
Name:JAMAL, SAIRA (MD)
Entity Type:Individual
Prefix:DR
First Name:SAIRA
Middle Name:
Last Name:JAMAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4320 WINDSOR CENTRE TRL
Mailing Address - Street 2:SUITE 300
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-1884
Mailing Address - Country:US
Mailing Address - Phone:972-539-1600
Mailing Address - Fax:972-539-1655
Practice Address - Street 1:4320 WINDSOR CENTRE TRL
Practice Address - Street 2:SUITE 300
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-1884
Practice Address - Country:US
Practice Address - Phone:972-539-1600
Practice Address - Fax:972-539-1655
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-29
Last Update Date:2017-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM9375207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN170680QMedicare ID - Type Unspecified
TX8L8610Medicare UPIN
TX200513401Medicaid
INH95993Medicare UPIN
TXP00813141Medicare PIN
TX8L8610Medicare PIN