1073657318 NPI number — SYED J. UMER, MD, PA

Table of content: (NPI 1073657318)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1073657318 NPI number — SYED J. UMER, MD, PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SYED J. UMER, MD, PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1073657318
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/14/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7234 HOVINGHAM
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN ANTONIO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78257-1364
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
210-681-6176
Provider Business Mailing Address Fax Number:
210-681-6157

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11130 CHRISTUS HILLS
Provider Second Line Business Practice Location Address:
SUITE 207 MEDICAL PLAZA 3
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78251
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-681-6176
Provider Business Practice Location Address Fax Number:
210-681-6157
Provider Enumeration Date:
02/19/2007

Additional Information

Authorized Official

Authorized Official Last Name:
UMER
Authorized Official First Name:
SYED
Authorized Official Middle Name:
JAVED
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
210-681-6176

Provider Taxonomy Codes

  • Taxonomy code: 207RC0000X , with the licence number:  K5232 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1073657318 . This is a "NPI" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 186799601 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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