Provider Demographics
NPI:1902216583
Name:IMAM, JAAFER SAADI (MD, PHD)
Entity Type:Individual
Prefix:
First Name:JAAFER
Middle Name:SAADI
Last Name:IMAM
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 UNIVERSITY BLVD JOHN SEALY ANNEX 5.140
Mailing Address - Street 2:
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77555-0001
Mailing Address - Country:US
Mailing Address - Phone:409-772-2436
Mailing Address - Fax:409-772-9532
Practice Address - Street 1:301 UNIVERSITY BLVD JOHN SEALY ANNEX 5.140
Practice Address - Street 2:
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77555-1865
Practice Address - Country:US
Practice Address - Phone:409-772-2436
Practice Address - Fax:409-772-9532
Is Sole Proprietor?:No
Enumeration Date:2014-05-05
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME128101207R00000X
TXS5663207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine