MEDICARE: JAMAL MUBARAK 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	207RP1001X	Pulmonary Disease Physician	K6658	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003839747
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMAL MUBARAK M.D.

Provider Business Mailing Address
First Line	:	209 N BONNIE BRAE ST STE 300
Second Line	:
City	:	DENTON
State	:	TX
Zip	:	76201-3749
Country	:	US
Telephone Number	:	940-382-5864
Fax Number	:	940-382-3939

Provider Business Practice Location Address
First Line	:	209 N. BONNIE BRAE STREET
Second Line	:	SUITE 300
City	:	DENTON
State	:	TX
Zip	:	76201-3708
Country	:	US
Telephone Number	:	940-382-5864
Fax Number	:	940-382-3939

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

Provider Enumeration Date	:	07/25/2006
Last Update Date	:	06/02/2026

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