# DR. HAMID REZA JALALI, D.O., P.A.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205085164
- **Authorized official:** DR. HAMID REZA JALALI D.O., P.A. (PHYSICIAN)
- **Authorized official phone:** (409) 745-4421

## Contact information

- **Practice address:** 11946 HWY 62 NORTH, ORANGE, TX 77632
- **Practice address phone:** (409) 745-4421
- **Mailing address:** PO BOX 966, MAURICEVILLE, TX 77626-0966
- **Mailing address phone:** (409) 745-4421

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | H0491 | TX | Yes |

## Other

- **Enumeration date:** 09/16/2008
- **Last updated:** 09/16/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 122951002 | — | TX |