Provider Demographics
NPI:1558306282
Name:JEFFRESS, ISABELLE F (MD)
Entity Type:Individual
Prefix:DR
First Name:ISABELLE
Middle Name:F
Last Name:JEFFRESS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 84170
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-0017
Mailing Address - Country:US
Mailing Address - Phone:281-412-6700
Mailing Address - Fax:281-412-6701
Practice Address - Street 1:6302 BROADWAY ST
Practice Address - Street 2:SUITE 130
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77581-7856
Practice Address - Country:US
Practice Address - Phone:281-412-6700
Practice Address - Fax:281-412-6701
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2012-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK0320207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
8F23433Medicare PIN