Healthcare Provider Details
I. General information
NPI: 1760496004
Provider Name (Legal Business Name): SAIRA JAMAL M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/29/2006
Last Update Date: 01/09/2025
Certification Date: 01/09/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4001 LONG PRAIRIE RD STE 123
FLOWER MOUND TX
75028-1528
US
IV. Provider business mailing address
4320 WINDSOR CENTRE TRL SUITE 300
FLOWER MOUND TX
75028-1884
US
V. Phone/Fax
- Phone: 469-495-9005
- Fax:
- Phone: 972-539-1600
- Fax: 972-539-1655
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207QG0300X |
| Taxonomy | Geriatric Medicine (Family Medicine) Physician |
| License Number | M9375 |
| License Number State | TX |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | M9375 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: