Provider Demographics
NPI:1790741676
Name:UMER, SYED JAVED (MD)
Entity Type:Individual
Prefix:
First Name:SYED
Middle Name:JAVED
Last Name:UMER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7234 HOVINGHAM
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78257
Mailing Address - Country:US
Mailing Address - Phone:210-681-6176
Mailing Address - Fax:210-681-6157
Practice Address - Street 1:11130 CHRISTUS HLS
Practice Address - Street 2:MEDICAL PLAZA 3, SUITE 207
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-3585
Practice Address - Country:US
Practice Address - Phone:210-228-0044
Practice Address - Fax:210-228-0045
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2017-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK5232207RC0000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX186799601Medicaid
TXTXB126182Medicare PIN
TX186799601Medicaid