Individual
NIRAN JAN AMAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
333 LONDONDERRY DR, STE 100, WACO, TX 76712-7930
(254) 751-1144
(254) 751-1185
Mailing address
333 LONDONDERRY DRIVE SUITE # 100, WACO, TX 76712
(254) 751-1144
(254) 751-1185
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
G2305
TX
207KI0005X
Clinical & Laboratory Immunology (Allergy & Immunology) Physician
G2305
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
030001522
RAILROAD MEDICARE
TX
05
—
100242002
—
TX
01
—
107463100
FIRST CARE
—
01
—
19715
SCOTT & WHITE
—
01
—
88290Y
BCBS
TX
Enumeration date
06/21/2005
Last updated
12/27/2021
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