MEDICARE: DR. ELHAM ZIAI- JAMALABADI 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	207Q00000X	Family Medicine Physician	M3439	TX

General Provider Information

NPI Number	:	1568433027
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELHAM ZIAI- JAMALABADI MD

Provider Business Mailing Address
First Line	:	1406 REIGER DR
Second Line	:
City	:	GREENVILLE
State	:	TX
Zip	:	75402-7619
Country	:	US
Telephone Number	:	903-454-7355
Fax Number	:

Provider Business Practice Location Address
First Line	:	4211 JOE RAMSEY BLVD E
Second Line	:
City	:	GREENVILLE
State	:	TX
Zip	:	75401-7852
Country	:	US
Telephone Number	:	903-408-7700
Fax Number	:

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

Provider Enumeration Date	:	01/31/2006
Last Update Date	:	04/13/2022

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