Basic Information
Provider Information
NPI: 1285215152
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ABU RAJAB ALTAMIMI
FirstName: ZAID
MiddleName: JAWAD M B
NamePrefix: DR.
NameSuffix:  
Credential: MBBS
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1 BAYLOR PLZ STE 405A
Address2:  
City: HOUSTON
State: TX
PostalCode: 770303498
CountryCode: US
TelephoneNumber: 8328223267
FaxNumber: 8328253251
Practice Location
Address1: 1 BAYLOR PLZ STE 405A
Address2:  
City: HOUSTON
State: TX
PostalCode: 770303498
CountryCode: US
TelephoneNumber: 8328223267
FaxNumber: 8328253251
Other Information
ProviderEnumerationDate: 04/21/2021
LastUpdateDate: 06/15/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/15/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  Y Student, Health CareStudent in an Organized Health Care Education/Training Program 

No ID Information.


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