Provider Demographics
NPI:1588818306
Name:JYOTHI N ACHI, MD PA
Entity Type:Organization
Organization Name:JYOTHI N ACHI, MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JYOTHI
Authorized Official - Middle Name:N
Authorized Official - Last Name:ACHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PA
Authorized Official - Phone:281-852-7500
Mailing Address - Street 1:22999 US HWY 59N
Mailing Address - Street 2:SUITE 232
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-4440
Mailing Address - Country:US
Mailing Address - Phone:281-852-7500
Mailing Address - Fax:281-852-7579
Practice Address - Street 1:22999 US HWY 59N
Practice Address - Street 2:SUITE 232
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-4440
Practice Address - Country:US
Practice Address - Phone:281-852-7500
Practice Address - Fax:281-852-7579
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-06
Last Update Date:2008-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL0966207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX141663801Medicaid
TX141663801Medicaid
TX00894MMedicare PIN