Individual
DR. ASHER S. IMAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
175 STONEBRIDGE LN STE 100, SOUTHLAKE, TX 76092-0307
(817) 421-2905
(817) 431-6459
Mailing address
175 STONEBRIDGE LN STE 100, SOUTHLAKE, TX 76092-0307
(817) 421-2905
(817) 431-6459
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
K9573
TX
2084N0600X
Clinical Neurophysiology Physician
K9573
TX
2084S0012X
Sleep Medicine (Psychiatry & Neurology) Physician
K9573
TX
2084V0102X
Vascular Neurology Physician
K9573
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
044094302
—
TX
Enumeration date
12/07/2006
Last updated
09/28/2020
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