1790741676 NPI number — SYED JAVED UMER MD

Table of content: SYED JAVED UMER MD (NPI 1790741676)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790741676 NPI number — SYED JAVED UMER MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
UMER
Provider First Name:
SYED
Provider Middle Name:
JAVED
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

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:
1790741676
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/19/2017
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
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 HLS
Provider Second Line Business Practice Location Address:
MEDICAL PLAZA 3, SUITE 207
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78251-3585
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-228-0044
Provider Business Practice Location Address Fax Number:
210-228-0045
Provider Enumeration Date:
04/21/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

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: 186799601 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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