Organization
DR. HAMID REZA JALALI, D.O., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HAMID REZA JALALI D.O., P.A. (PHYSICIAN)
(409) 745-4421
Entity
Organization
Contact information
Practice address
11946 HWY 62 NORTH, ORANGE, TX 77632
(409) 745-4421
Mailing address
PO BOX 966, MAURICEVILLE, TX 77626-0966
(409) 745-4421
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
H0491
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
122951002
—
TX
Enumeration date
09/16/2008
Last updated
09/16/2008
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