Provider Demographics
NPI:1992383608
Name:JILANI, SYED MUHAMMAD ALI AHMED (MD)
Entity type:Individual
Prefix:
First Name:SYED MUHAMMAD ALI
Middle Name:AHMED
Last Name:JILANI
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3080 MILAM ST
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77701-4828
Mailing Address - Country:US
Mailing Address - Phone:409-347-3621
Mailing Address - Fax:409-860-9078
Practice Address - Street 1:3080 MILAM ST
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77701-4828
Practice Address - Country:US
Practice Address - Phone:409-347-3621
Practice Address - Fax:409-860-9078
Is Sole Proprietor?:No
Enumeration Date:2021-04-01
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXU8746207R00000X
TX1265971691390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine