Provider Demographics
NPI:1134158074
Name:MOHSIN, JAMIL CHAUDHRY (MD)
Entity type:Individual
Prefix:
First Name:JAMIL
Middle Name:CHAUDHRY
Last Name:MOHSIN
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 1:11611 SPRING CYPRESS RD B
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77377-8918
Mailing Address - Country:US
Mailing Address - Phone:832-688-9479
Mailing Address - Fax:832-604-7466
Practice Address - Street 1:11611 SPRING CYPRESS RD
Practice Address - Street 2:STE B
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77377-8918
Practice Address - Country:US
Practice Address - Phone:832-688-9479
Practice Address - Fax:832-604-7466
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-02
Last Update Date:2015-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD072363L207RC0000X
TXM3648207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00908027OtherMEDICARE RR
3496OtherCERT. BOARD OF NUCL. CARD
TX215018701Medicaid
TXP00908027OtherMEDICARE RR
TXTXB107135Medicare PIN
TX215018701Medicaid