Provider Demographics
NPI:1134128119
Name:JONES, GENE E (MD)
Entity Type:Individual
Prefix:
First Name:GENE
Middle Name:E
Last Name:JONES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2875 JIMMY JOHNSON BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:PORT ARTHUR
Mailing Address - State:TX
Mailing Address - Zip Code:77640-2002
Mailing Address - Country:US
Mailing Address - Phone:409-729-9222
Mailing Address - Fax:409-722-9425
Practice Address - Street 1:2875 JIMMY JOHNSON BLVD STE 100
Practice Address - Street 2:
Practice Address - City:PORT ARTHUR
Practice Address - State:TX
Practice Address - Zip Code:77640-2002
Practice Address - Country:US
Practice Address - Phone:409-729-9222
Practice Address - Fax:409-722-9425
Is Sole Proprietor?:No
Enumeration Date:2005-07-20
Last Update Date:2016-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD1690207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX128460603Medicaid
TX00194ZOtherMEDICARE PTAN
TX00K699Medicare PIN
TXC17609Medicare UPIN