Provider Demographics
NPI:1255481693
Name:GREER-BRUMBAUGH, JEANNETTE MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:JEANNETTE
Middle Name:MARIE
Last Name:GREER-BRUMBAUGH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JEANNETTE
Other - Middle Name:MARIE
Other - Last Name:GREER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2450 FONDREN RD
Mailing Address - Street 2:SUITE 311
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-2318
Mailing Address - Country:US
Mailing Address - Phone:713-621-8660
Mailing Address - Fax:713-621-3730
Practice Address - Street 1:2450 FONDREN RD
Practice Address - Street 2:SUITE 311
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-2318
Practice Address - Country:US
Practice Address - Phone:713-621-8660
Practice Address - Fax:713-621-3730
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2011-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH6256207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXH6256OtherSTATE LICENSE
TXH6256OtherSTATE LICENSE
TX00K25XMedicare PIN