Provider Demographics
NPI:1114288743
Name:PIMENTEL, JESUS JAVIER (MD)
Entity Type:Individual
Prefix:DR
First Name:JESUS
Middle Name:JAVIER
Last Name:PIMENTEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:6560 FANNIN ST
Mailing Address - Street 2:SUITE 1950
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2761
Mailing Address - Country:US
Mailing Address - Phone:713-441-4280
Mailing Address - Fax:713-790-2860
Practice Address - Street 1:6560 FANNIN ST
Practice Address - Street 2:SUITE 1950
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2761
Practice Address - Country:US
Practice Address - Phone:713-441-4280
Practice Address - Fax:713-790-2860
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-30
Last Update Date:2015-08-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TX566819207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8FF355OtherBLUE CROSS BLUE SHIELD
TX425591YMVQMedicare PIN