Physician Compare National (NPI:1598791113)

HEALTHCARE PROVIDER: IMTIHAN M JAWDAT MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1598791113
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4688694250
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20091019000206
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	JAWDAT
	Individual professional last name
Provider First Name	IMTIHAN
	Individual professional first name
Provider Middle Name	M
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1969
	Individual professional's medical school graduation year
Primary Specialty	CARDIOVASCULAR DISEASE (CARDIOLOGY)
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	8901 FM 1960 RD W
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 304
	Group Practice or individual's line 2 address
City	HUMBLE
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	773384125
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y