Provider Demographics
NPI:1396356994
Name:JESMA MEDICAL CONSULTANTS LLC
Entity Type:Organization
Organization Name:JESMA MEDICAL CONSULTANTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:UJU
Authorized Official - Middle Name:
Authorized Official - Last Name:ANYANWU
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:443-857-2601
Mailing Address - Street 1:4209 CREEK FALLS DR
Mailing Address - Street 2:
Mailing Address - City:CORINTH
Mailing Address - State:TX
Mailing Address - Zip Code:76208-5187
Mailing Address - Country:US
Mailing Address - Phone:443-857-2601
Mailing Address - Fax:
Practice Address - Street 1:4209 CREEK FALLS DR
Practice Address - Street 2:
Practice Address - City:CORINTH
Practice Address - State:TX
Practice Address - Zip Code:76208-5187
Practice Address - Country:US
Practice Address - Phone:443-857-2601
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-17
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty