Provider Demographics
NPI:1427000827
Name:HOLMES, JEANE SIMMONS (MD)
Entity Type:Individual
Prefix:DR
First Name:JEANE
Middle Name:SIMMONS
Last Name:HOLMES
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 1:1601 ST JOSEPH PKWY
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77003-5001
Mailing Address - Country:US
Mailing Address - Phone:713-757-5616
Mailing Address - Fax:
Practice Address - Street 1:1601 ST JOSEPH PKWY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77003-5001
Practice Address - Country:US
Practice Address - Phone:713-757-7406
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2010-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ5124207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8S5379OtherBLUE CROSS BLUE SHIELD
TXP00101656OtherRAILROAD MEDICARE
TX096918004Medicaid
TX8G7173OtherBLUE CROSS BLUE SHIELD
TX096918006Medicaid
TX096918004Medicaid
TX8G6161Medicare PIN
TX8G7173OtherBLUE CROSS BLUE SHIELD