Provider Demographics
NPI:1376990986
Name:FERDOUS, MST JANNATUL (MD)
Entity Type:Individual
Prefix:DR
First Name:MST
Middle Name:JANNATUL
Last Name:FERDOUS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3601 4TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79430-8321
Mailing Address - Country:US
Mailing Address - Phone:806-743-2391
Mailing Address - Fax:806-743-5687
Practice Address - Street 1:3601 4TH ST
Practice Address - Street 2:STOP 8321
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79430-8321
Practice Address - Country:US
Practice Address - Phone:806-743-2391
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-24
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR36712084N0600X, 2084N0400X, 2084E0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology
No2084E0001XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyEpilepsy