Individual
MR. SAMER IZZAT JIFI-BAHLOOL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
614 FURMAN AVE, CORPUS CHRISTI, TX 78404-2325
(361) 882-9278
(361) 882-9279
Mailing address
PO BOX 60041, CORPUS CHRISTI, TX 78466-0041
(361) 882-9278
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
L0304
TX
207RN0300X
Nephrology Physician
Primary
L0304
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
046256601
—
TX
01
—
74-2617515
TAX ID
TX
Enumeration date
06/26/2006
Last updated
09/08/2014
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