Provider Demographics
NPI:1134870827
Name:DAHER, JAMAL-EDDIN H (PA-C)
Entity type:Individual
Prefix:MR
First Name:JAMAL-EDDIN
Middle Name:H
Last Name:DAHER
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10807 PERRIN BEITEL RD STE 300
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78217-3144
Mailing Address - Country:US
Mailing Address - Phone:210-245-7862
Mailing Address - Fax:
Practice Address - Street 1:10807 PERRIN BEITEL RD STE 300
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-3144
Practice Address - Country:US
Practice Address - Phone:210-245-7862
Practice Address - Fax:210-245-7951
Is Sole Proprietor?:No
Enumeration Date:2022-01-13
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA15345363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant