Provider Demographics
NPI:1144269192
Name:ZEGAR, AMIR (DO)
Entity type:Individual
Prefix:
First Name:AMIR
Middle Name:
Last Name:ZEGAR
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77007-5673
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4000 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77007-5673
Practice Address - Country:US
Practice Address - Phone:281-501-2841
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2016-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM7787207PE0004X, 207P00000X
MI5101015806207P00000X
ALM7787207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX188092405Medicaid
TX188092416Medicaid
TX188092407Medicaid
TX188092416Medicaid
TX8F23244Medicare Oscar/Certification
TX8K6844Medicare PIN
TX8K6865Medicare PIN
MII45318Medicare UPIN