MEDICARE: AMBROSE MOBILE HEALTH CARE ASSOCIATION

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	207W00000X	Ophthalmology Physician

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	:	1619126109
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMBROSE MOBILE HEALTH CARE ASSOCIATION

Provider Business Mailing Address
First Line	:	PO BOX 270926
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77277-0926
Country	:	US
Telephone Number	:	281-441-3311
Fax Number	:	281-441-3313

Provider Business Practice Location Address
First Line	:	5970 N SAM HOUSTON PKWY E STE 505
Second Line	:
City	:	HUMBLE
State	:	TX
Zip	:	77396-3258
Country	:	US
Telephone Number	:	281-441-3311
Fax Number	:	281-441-3313

Authorized Official
Title or Position	:	SOLE OWNER
Name	:	FIAZ ZAMAN
Credential	:	MD
Telephone Number	:	281-441-3311

Provider Enumeration Date	:	09/09/2008
Last Update Date	:	09/09/2008

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