| Mr Jamal A Zereik, MD | |
|
1333 S Sam Houston Blvd, Houston, MO 65483-2046 | |
| (417) 967-3311 | |
| (417) 967-1259 |
| Full Name | Mr Jamal A Zereik |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Location | 1333 S Sam Houston Blvd, Houston, Missouri |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437104999 | NPI | - | NPPES |
| 204664015 | Medicaid | MO | |
| 1437104999 | Medicaid | MO | |
| 26D0446923 | Other | MO | CLIA |
| G99887 | Other | MO | UPIN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | 119678 (Missouri) | Secondary |
| 208D00000X | General Practice | 119678 (Missouri) | Secondary |
| 207P00000X | Emergency Medicine | 119678 (Missouri) | Primary |
| Entity Name | Texas County Memorial Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1790740363 PECOS PAC ID: 9436041696 Enrollment ID: O20040401000307 |
| Entity Name | Theoria Medical |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1609362375 PECOS PAC ID: 5395098339 Enrollment ID: O20240919002593 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Jamal A Zereik, MD 1333 S Sam Houston Blvd, Houston, MO 65483-2046 Ph: (417) 967-3311 | Mr Jamal A Zereik, MD 1333 S Sam Houston Blvd, Houston, MO 65483-2046 Ph: (417) 967-3311 |
Selina A Jeanise, DO Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 1333 S Sam Houston Blvd, Houston, MO 65483 Phone: 417-967-5435 | |
Dr. Louise Wilkinson, DO Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 1333 S Sam Houston Blvd, Houston, MO 65483 Phone: 417-967-3311 Fax: 417-967-1259 |