MEDICARE: JASMINE INTERNAL MEDICINE CLINIC PLLC

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	261QP2300X	Primary Care Clinic/Center
2	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1073385027
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JASMINE INTERNAL MEDICINE CLINIC PLLC

Provider Business Mailing Address
First Line	:	7417 W GRAND PKWY S STE 150
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77407-8901
Country	:	US
Telephone Number	:	210-802-8919
Fax Number	:

Provider Business Practice Location Address
First Line	:	7417 W GRAND PKWY S STE 150
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77407-8901
Country	:	US
Telephone Number	:	210-802-8919
Fax Number	:

Authorized Official
Title or Position	:	MD
Name	:	HIND NEAMAH
Credential	:	MD
Telephone Number	:	210-802-8919

Provider Enumeration Date	:	10/24/2023
Last Update Date	:	10/24/2023

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