Provider Demographics
NPI:1902973183
Name:JAMAL, AMIN R (MD,PA)
Entity Type:Individual
Prefix:DR
First Name:AMIN
Middle Name:R
Last Name:JAMAL
Suffix:
Gender:M
Credentials:MD,PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7777 SOUTHWEST FREEWAY
Mailing Address - Street 2:SUITE 534
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074
Mailing Address - Country:US
Mailing Address - Phone:713-270-1800
Mailing Address - Fax:713-270-1803
Practice Address - Street 1:7777 SOUTHWEST FWY
Practice Address - Street 2:SUITE #802
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-1802
Practice Address - Country:US
Practice Address - Phone:713-270-1800
Practice Address - Fax:713-270-1803
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK8231174400000X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX760616728OtherTAX ID
TX460003089OtherMEDICARE RAILROAD
TX0017EWOtherBLUE CROSS BLUE SHILED
TX2458724OtherAETNA
TX030806601Medicaid
TX030806601Medicaid
TX2458724OtherAETNA