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Individual

NADIM BIN ISLAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
504 MEDICAL CENTER BLVD, CONROE, TX 77304-2808
(409) 539-1111
(409) 788-8044
Mailing address
PO BOX 200993, HOUSTON, TX 77216-0993
(281) 784-1111
(281) 784-1555

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
M0116
TX
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
M0116
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1457324972
TRICARE SOUTH
TX
05
1772659-02
TX
05
177265901
TX
05
177265906
TX
01
8P5092
BCBSTX PROV NO
TX
Enumeration date
02/08/2006
Last updated
03/26/2010
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