Provider Demographics
NPI:1477581205
Name:JARAMILLO, EDUARDO L (MD)
Entity Type:Individual
Prefix:DR
First Name:EDUARDO
Middle Name:L
Last Name:JARAMILLO
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 1:2400 HIGHWAY 365
Mailing Address - Street 2:SUITE 207
Mailing Address - City:NEDERLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77627-6249
Mailing Address - Country:US
Mailing Address - Phone:409-853-1882
Mailing Address - Fax:409-722-0622
Practice Address - Street 1:2400 HIGHWAY 365
Practice Address - Street 2:SUITE 207
Practice Address - City:NEDERLAND
Practice Address - State:TX
Practice Address - Zip Code:77627-6249
Practice Address - Country:US
Practice Address - Phone:409-853-1882
Practice Address - Fax:409-722-0622
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2015-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM4204207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8J8026OtherMEDICARE ID
TX182280101Medicaid
TX8F3601Medicare ID - Type Unspecified
TX8J8026OtherMEDICARE ID