MEDICARE: AISHAH JEHAD SULEIMAN MD

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	207R00000X	Internal Medicine Physician	R4478	TX

General Provider Information

NPI Number	:	1073933065
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AISHAH JEHAD SULEIMAN MD

Provider Business Mailing Address
First Line	:	4714 FM 1488 RD STE 603
Second Line	:
City	:	CONROE
State	:	TX
Zip	:	77384-4928
Country	:	US
Telephone Number	:	940-867-4271
Fax Number	:	936-242-1581

Provider Business Practice Location Address
First Line	:	4714 FM 1488 RD STE 603
Second Line	:
City	:	CONROE
State	:	TX
Zip	:	77384-4928
Country	:	US
Telephone Number	:	936-242-1589
Fax Number	:	936-242-1581

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

Provider Enumeration Date	:	04/17/2014
Last Update Date	:	11/04/2024

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