Provider Demographics
NPI:1518686153
Name:MINNIEWEATHER, JAKARI JAMAL
Entity Type:Individual
Prefix:
First Name:JAKARI
Middle Name:JAMAL
Last Name:MINNIEWEATHER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 E WHITNEY ST # 2
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77022-3529
Mailing Address - Country:US
Mailing Address - Phone:832-348-6495
Mailing Address - Fax:
Practice Address - Street 1:3822 OLD SPANISH TRL
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77021-1340
Practice Address - Country:US
Practice Address - Phone:713-741-7323
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-25
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program