Provider Demographics
NPI:1487648481
Name:JONES, JEFFERY JAMES (PHD)
Entity Type:Individual
Prefix:DR
First Name:JEFFERY
Middle Name:JAMES
Last Name:JONES
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17115 RED OAK DR
Mailing Address - Street 2:STE 109
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77090-2607
Mailing Address - Country:US
Mailing Address - Phone:281-893-4111
Mailing Address - Fax:281-893-8082
Practice Address - Street 1:17115 RED OAK DR
Practice Address - Street 2:STE 109
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-2607
Practice Address - Country:US
Practice Address - Phone:281-893-4111
Practice Address - Fax:281-893-8082
Is Sole Proprietor?:No
Enumeration Date:2005-09-06
Last Update Date:2010-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24686103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX036094302Medicaid
TX83096PMedicare ID - Type Unspecified
TX036094302Medicaid