Individual
DR. IMRAN ADAM MEMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1001 PENNSYLVANIA AVE, FORT WORTH, TX 76104-2228
(817) 877-5858
(817) 335-4418
Mailing address
1000 W CANNON ST, FORT WORTH, TX 76104-3029
(817) 877-5858
(817) 335-4418
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
P1199
TX
207RN0300X
Nephrology Physician
4301079766
MI
207RN0300X
Nephrology Physician
Primary
P1199
TX
208000000X
Pediatrics Physician
4301079766
MI
2080P0210X
Pediatric Nephrology Physician
4301079766
MI
2080P0210X
Pediatric Nephrology Physician
P1199
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2007004327
MISSOURI LICENSE NUMBER
MO
05
—
321658201
—
TX
01
—
N0195877
DPS
TX
01
—
P1199
TEXAS LICENSE
TX
Enumeration date
11/16/2007
Last updated
04/02/2025
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