Provider Demographics
NPI:1225487192
Name:JAYAKUMAR, KARTHIK (MD)
Entity Type:Individual
Prefix:
First Name:KARTHIK
Middle Name:
Last Name:JAYAKUMAR
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 1:12305 MURANO DR
Mailing Address - Street 2:
Mailing Address - City:TEXAS CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77568-2555
Mailing Address - Country:US
Mailing Address - Phone:281-691-5043
Mailing Address - Fax:
Practice Address - Street 1:10121 EMMETT F LOWRY EXPY
Practice Address - Street 2:
Practice Address - City:TEXAS CITY
Practice Address - State:TX
Practice Address - Zip Code:77591-2286
Practice Address - Country:US
Practice Address - Phone:409-986-9686
Practice Address - Fax:409-986-7890
Is Sole Proprietor?:No
Enumeration Date:2016-06-10
Last Update Date:2019-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10057232207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine