Jifi-Bahlool, Samer Izzat

Jifi-Bahlool, Samer Izzat is an individual health care provider with primary practice located at 614 Furman Ave , Corpus Christi TX 78404-2325. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Nephrology, Other Service Providers / Specialist. Allopathic & Osteopathic Physicians / Nephrology is his primary health care specialty. Jifi-Bahlool, Samer Izzat can be contacted via phone (361) 882-9278.

Contact Information

Primary practice address
614 Furman Ave Corpus Christi TX 78404-2325
Phone: (361) 882-9278
Fax: (361) 882-9279
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X L0304 Texas
Other Service Providers / Specialist 174400000X L0304 Texas

Profile Details

NPI number 1881621118
LBN Legal business name Jifi-Bahlool, Samer Izzat
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 26th, 2006
Last updated Sep 8th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1881621118 NPPES
Texas Other 74-2617515 TAX ID
Texas MEDICAID 046256601 TAX ID

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