Provider Demographics
NPI:1093048068
Name:EDUARDO L JARAMILLO MD PA
Entity Type:Organization
Organization Name:EDUARDO L JARAMILLO MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:EDUARDO
Authorized Official - Middle Name:L
Authorized Official - Last Name:JARAMILLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:409-853-1882
Mailing Address - Street 1:2400 HIGHWAY 365 STE 207
Mailing Address - Street 2:
Mailing Address - City:NEDERLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77627-6250
Mailing Address - Country:US
Mailing Address - Phone:409-853-1882
Mailing Address - Fax:409-722-0622
Practice Address - Street 1:2400 HIGHWAY 365 STE 207
Practice Address - Street 2:
Practice Address - City:NEDERLAND
Practice Address - State:TX
Practice Address - Zip Code:77627-6250
Practice Address - Country:US
Practice Address - Phone:409-853-1882
Practice Address - Fax:409-722-0622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-09
Last Update Date:2009-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM4204207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty