Provider Demographics
NPI:1053548891
Name:MORI, AMIT (MD)
Entity type:Individual
Prefix:
First Name:AMIT
Middle Name:
Last Name:MORI
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 131661
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77393-1661
Mailing Address - Country:US
Mailing Address - Phone:281-698-7070
Mailing Address - Fax:480-685-9922
Practice Address - Street 1:500 MEDICAL CENTER BLVD STE 235
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-2800
Practice Address - Country:US
Practice Address - Phone:281-698-7070
Practice Address - Fax:480-685-9922
Is Sole Proprietor?:No
Enumeration Date:2009-06-19
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.000289207RG0100X
SC89081207RG0100X
IL036169986207RG0100X
TXR6247207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCQ0130OMedicaid
TXR6247OtherTEXAS STATE LICENSE