Provider Demographics
NPI:1497851539
Name:HYMAN, JONATHAN DAVID (DPM)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:DAVID
Last Name:HYMAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5959 WEST LOOP S
Mailing Address - Street 2:SUITE 130
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-2421
Mailing Address - Country:US
Mailing Address - Phone:713-666-9934
Mailing Address - Fax:713-666-8659
Practice Address - Street 1:5959 WEST LOOP S
Practice Address - Street 2:SUITE 130
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-2421
Practice Address - Country:US
Practice Address - Phone:713-666-9934
Practice Address - Fax:713-666-8659
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2012-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0387213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX119889702Medicaid
TX0586720001Medicare NSC
TXT13988Medicare UPIN
TX119889702Medicaid