Basic Information
| Provider Information | |||||||||
| NPI: | 1902216583 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | IMAM | ||||||||
| FirstName: | JAAFER | ||||||||
| MiddleName: | SAADI | ||||||||
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| Credential: | MD, PHD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 301 UNIVERSITY BLVD JOHN SEALY ANNEX 5.140 | ||||||||
| Address2: | |||||||||
| City: | GALVESTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 775550001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4097722436 | ||||||||
| FaxNumber: | 4097729532 | ||||||||
| Practice Location | |||||||||
| Address1: | 301 UNIVERSITY BLVD JOHN SEALY ANNEX 5.140 | ||||||||
| Address2: | |||||||||
| City: | GALVESTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 775551865 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4097722436 | ||||||||
| FaxNumber: | 4097729532 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/05/2014 | ||||||||
| LastUpdateDate: | 11/14/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | ME128101 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.