| Dr. Hamid Reza Jalali, D.o., P.a. | |
|
11946 Hwy 62 North Orange TX 77632 | |
| (409) 745-4421 | |
| Not Available |
| Full Name | Dr. Hamid Reza Jalali, D.o., P.a. |
|---|---|
| Speciality | General Practice |
| Location | 11946 Hwy 62 North, Orange, Texas |
| Authorized Official Name and Position | Hamid Reza Jalali (PHYSICIAN) |
| Authorized Official Contact | 4097454421 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Hamid Reza Jalali, D.o., P.a. Po Box 966 Mauriceville TX 77626-0966 Ph: (409) 745-4421 | Dr. Hamid Reza Jalali, D.o., P.a. 11946 Hwy 62 North Orange TX 77632 Ph: (409) 745-4421 |
| NPI Number | 1205085164 |
|---|---|
| Provider Enumeration Date | 09/16/2008 |
| Last Update Date | 09/16/2008 |
| Medicare PECOS PAC ID | 7618036757 |
|---|---|
| Medicare Enrollment ID | O20081105000157 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205085164 | NPI | - | NPPES |
| 122951002 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | H0491 (Texas) | Primary |
| Provider Name | Hamid R Jalali |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033115076 PECOS PAC ID: 1456410596 Enrollment ID: I20081105000140 |
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