Healthcare Provider Details

I. General information

NPI: 1730389966
Provider Name (Legal Business Name): WOODLANDS INTERNISTS ,P.A
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2007
Last Update Date: 08/30/2023
Certification Date: 08/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4185 TECHNOLOGY FOREST BLVD STE 150
THE WOODLANDS TX
77381-2005
US

IV. Provider business mailing address

PO BOX 132795
THE WOODLANDS TX
77393-2795
US

V. Phone/Fax

Practice location:
  • Phone: 936-273-2016
  • Fax: 936-273-2018
Mailing address:
  • Phone: 936-273-2016
  • Fax: 936-273-2018

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: NADEEM JAMIL
Title or Position: OWNER
Credential: MD
Phone: 936-273-2016