Provider Demographics
NPI:1992383608
Name:JILANI, SYED MUHAMMAD ALI AHMED (MD)
Entity type:Individual
Prefix:
First Name:SYED MUHAMMAD ALI
Middle Name:AHMED
Last Name:JILANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3406 COLLEGE ST STE 200
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77701-4612
Mailing Address - Country:US
Mailing Address - Phone:409-813-1677
Mailing Address - Fax:409-736-7167
Practice Address - Street 1:2353 N MAIN ST
Practice Address - Street 2:
Practice Address - City:VIDOR
Practice Address - State:TX
Practice Address - Zip Code:77662-2610
Practice Address - Country:US
Practice Address - Phone:409-813-1677
Practice Address - Fax:409-422-4997
Is Sole Proprietor?:No
Enumeration Date:2021-04-01
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXU8746207R00000X
TX1265971691390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine