Provider Demographics
NPI:1225187685
Name:VO, JERRI
Entity Type:Individual
Prefix:DR
First Name:JERRI
Middle Name:
Last Name:VO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7022 HIGHWAY 6 STE 700
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-5159
Mailing Address - Country:US
Mailing Address - Phone:281-261-3332
Mailing Address - Fax:281-261-3335
Practice Address - Street 1:7022 HIGHWAY 6 STE 700
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-5159
Practice Address - Country:US
Practice Address - Phone:281-261-3332
Practice Address - Fax:281-261-3335
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX212101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX171014704Medicaid