Provider Demographics
NPI:1003165416
Name:JERRY OAKMAN MD PLLC
Entity Type:Organization
Organization Name:JERRY OAKMAN MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:DENNIS
Authorized Official - Last Name:OAKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-890-8610
Mailing Address - Street 1:12850 JONES RD
Mailing Address - Street 2:STE#102
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-4955
Mailing Address - Country:US
Mailing Address - Phone:281-890-8610
Mailing Address - Fax:281-890-8613
Practice Address - Street 1:12850 JONES RD
Practice Address - Street 2:STE#102
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-4955
Practice Address - Country:US
Practice Address - Phone:281-890-8610
Practice Address - Fax:281-890-8613
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-30
Last Update Date:2012-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE3078208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty