Provider Demographics
NPI:1346414398
Name:JAYARAMAN, GNANANANDH (MD)
Entity Type:Individual
Prefix:DR
First Name:GNANANANDH
Middle Name:
Last Name:JAYARAMAN
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 1:451 KINGWOOD MEDICAL DR STE 100
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-6408
Mailing Address - Country:US
Mailing Address - Phone:281-318-2043
Mailing Address - Fax:281-360-6306
Practice Address - Street 1:451 KINGWOOD MEDICAL DR STE 100
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339
Practice Address - Country:US
Practice Address - Phone:281-318-2043
Practice Address - Fax:281-360-6306
Is Sole Proprietor?:No
Enumeration Date:2008-04-21
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01053542A207R00000X
TXBP10023489207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVH39724Medicare UPIN
OHH39724Medicare UPIN