Individual
JEREMY FAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
301 UNIVERSITY BLVD, GALVESTON, TX 77555-5302
(409) 266-7856
Mailing address
PO BOX 650859, DALLAS, TX 75265-0859
(409) 772-2222
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
BP10084377
TX
Other
Enumeration date
05/12/2023
Last updated
05/12/2023
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