MEDICARE: NIRAN JAN AMAR M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207KI0005X	Clinical & Laboratory Immunology (Allergy & Immunology) Physician	G2305	TX
2	207K00000X	Allergy & Immunology Physician	G2305	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	030001522	OTHER	TX	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	19715	OTHER		SCOTT & WHITE
2	107463100	OTHER		FIRST CARE
3	88290Y	OTHER	TX	BCBS
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003812595
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NIRAN JAN AMAR M.D.

Provider Business Mailing Address
First Line	:	333 LONDONDERRY DRIVE SUITE # 100
Second Line	:
City	:	WACO
State	:	TX
Zip	:	76712
Country	:	US
Telephone Number	:	254-751-1144
Fax Number	:	254-751-1185

Provider Business Practice Location Address
First Line	:	333 LONDONDERRY DR
Second Line	:	STE 100
City	:	WACO
State	:	TX
Zip	:	76712-7930
Country	:	US
Telephone Number	:	254-751-1144
Fax Number	:	254-751-1185

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/21/2005
Last Update Date	:	12/27/2021

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Directions to “ NIRAN JAN AMAR M.D.” Practice Location

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