Provider Demographics
NPI:1376794750
Name:MUELLER, ERIC JAY (MD)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:JAY
Last Name:MUELLER
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 1:6560 FANNIN ST STE 1950
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2710
Mailing Address - Country:US
Mailing Address - Phone:713-441-4280
Mailing Address - Fax:713-790-2860
Practice Address - Street 1:6560 FANNIN ST
Practice Address - Street 2:STE 1950
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2761
Practice Address - Country:US
Practice Address - Phone:713-441-4280
Practice Address - Fax:713-790-2860
Is Sole Proprietor?:No
Enumeration Date:2008-10-03
Last Update Date:2016-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN8045207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8CQ200OtherBLUE CROSS BLUE SHIELD
TX8EF365OtherBLUE CROSS BLUE SHIELD
TXP00917504OtherMEDICARE RR
TXTXB118778Medicare PIN
TX341595YMVQMedicare PIN