Provider Demographics
NPI:1093829962
Name:LI, JESSIE Z (OMD)
Entity Type:Individual
Prefix:MS
First Name:JESSIE
Middle Name:Z
Last Name:LI
Suffix:
Gender:F
Credentials:OMD
Other - Prefix:DR
Other - First Name:JESSIE
Other - Middle Name:
Other - Last Name:LI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OMD
Mailing Address - Street 1:12335 SHADOW GREEN DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-5642
Mailing Address - Country:US
Mailing Address - Phone:281-870-8818
Mailing Address - Fax:
Practice Address - Street 1:8989 WESTHEIMER RD.
Practice Address - Street 2:STE.301
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063
Practice Address - Country:US
Practice Address - Phone:713-988-8849
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2008-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC00012171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist