Provider Demographics
NPI:1063662435
Name:WILNER E JEUDY M.D,P.A
Entity Type:Organization
Organization Name:WILNER E JEUDY M.D,P.A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:WILNER
Authorized Official - Middle Name:E
Authorized Official - Last Name:JEUDY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-715-6411
Mailing Address - Street 1:8313 SOUTHWEST FWY
Mailing Address - Street 2:SUITE 201
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-1611
Mailing Address - Country:US
Mailing Address - Phone:713-715-6411
Mailing Address - Fax:832-252-1501
Practice Address - Street 1:8313 SOUTHWEST FWY
Practice Address - Street 2:SUITE 201
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-1611
Practice Address - Country:US
Practice Address - Phone:713-715-6411
Practice Address - Fax:832-252-1501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-23
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK6474261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care