Individual
JERMALE SAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1500 CITYWEST BLVD, STE. 300, HOUSTON, TX 77042-2300
(713) 620-4000
(713) 458-4229
Mailing address
11511 SHADOW CREEK PKWY, PEARLAND, TX 77584-7298
(713) 442-0000
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
Q5557
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
349593901
—
TX
01
—
8FN447
BCBS
TX
01
—
P01580991
RR MEDICARE
TX
Enumeration date
07/27/2010
Last updated
10/10/2023
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