Provider Demographics
NPI:1346235025
Name:TURNER, ROD JAY SR (MD)
Entity Type:Individual
Prefix:DR
First Name:ROD
Middle Name:JAY
Last Name:TURNER
Suffix:SR
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 1:402 BLOSSOM ST
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-4208
Mailing Address - Country:US
Mailing Address - Phone:281-554-3107
Mailing Address - Fax:281-557-0372
Practice Address - Street 1:402 BLOSSOM ST
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4208
Practice Address - Country:US
Practice Address - Phone:281-554-3107
Practice Address - Fax:281-557-0372
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-19
Last Update Date:2016-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ0799207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX121350601Medicaid
TX121350601Medicaid
TX00347GMedicare ID - Type UnspecifiedMEDICARE NUMBER