Provider Demographics
NPI:1831192319
Name:RAZZACK, JAMAL A (MD)
Entity type:Individual
Prefix:DR
First Name:JAMAL
Middle Name:A
Last Name:RAZZACK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JAMAL
Other - Middle Name:A
Other - Last Name:RAZZACK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:10837 KATY FREEWAY
Mailing Address - Street 2:STE. 250
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079-2205
Mailing Address - Country:US
Mailing Address - Phone:713-464-8098
Mailing Address - Fax:713-465-1921
Practice Address - Street 1:10837 KATY FREEWAY
Practice Address - Street 2:STE. 250
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-2205
Practice Address - Country:US
Practice Address - Phone:713-464-8098
Practice Address - Fax:713-465-1921
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2014-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK4205207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX151461401Medicaid
TX1819788OtherUNITEDHEALTHCARE
TX3761270OtherCIGNA
TX1629103221OtherMEMORIAL PULMONARY AND SLEEP DISORDERS ASSOCIATES
TX1831192319OtherNPI
TX10023338OtherAMERIGROUP TEXAS
TX290014706OtherRAILROAD MEDICARE
TX0050KAOtherBCBS
TX5672615OtherAETNAHEALTHCARE
TX8539B0OtherMEDICARE PROVIDER
TX5672615OtherAETNAHEALTHCARE
TX151461401Medicaid