| Optimum Ambulatory Health Pllc | |
|
2409 Falcon Pass Dr Ste 100 Houston TX 77062-6276 | |
| (281) 461-1111 | |
| (281) 461-6860 |
| Full Name | Optimum Ambulatory Health Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2409 Falcon Pass Dr Ste 100, Houston, Texas |
| Authorized Official Name and Position | James T Jackson (MEDICAL DIRECTOR) |
| Authorized Official Contact | 2814611111 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Optimum Ambulatory Health Pllc 2409 Falcon Pass Dr Ste 100 Houston TX 77062-6276 Ph: (281) 461-1111 | Optimum Ambulatory Health Pllc 2409 Falcon Pass Dr Ste 100 Houston TX 77062-6276 Ph: (281) 461-1111 |
| NPI Number | 1174199707 |
|---|---|
| Provider Enumeration Date | 06/03/2021 |
| Last Update Date | 11/05/2021 |
| Medicare PECOS PAC ID | 6204225519 |
|---|---|
| Medicare Enrollment ID | O20211108001228 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174199707 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | James T Jackson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396766176 PECOS PAC ID: 0749186856 Enrollment ID: I20031210000135 |
| Provider Name | Kashif Ahmed Siddiqui |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154636561 PECOS PAC ID: 5092977066 Enrollment ID: I20120509000177 |
| Provider Name | Mary V Price |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649682139 PECOS PAC ID: 7517187594 Enrollment ID: I20140926000421 |
| Provider Name | Laura H Gordon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639547524 PECOS PAC ID: 3476842816 Enrollment ID: I20160525000721 |
| Provider Name | Sajid R Khan |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1326084039 PECOS PAC ID: 3678667052 Enrollment ID: I20171121001411 |
| Provider Name | Pamela James |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346880028 PECOS PAC ID: 0244660207 Enrollment ID: I20200415002864 |
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