Provider Demographics
NPI:1619041175
Name:JAYAKUMAR, THIRUMALAIRAJ (MD)
Entity Type:Individual
Prefix:
First Name:THIRUMALAIRAJ
Middle Name:
Last Name:JAYAKUMAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7737 SOUTHWEST FREEWAY
Mailing Address - Street 2:#830
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074
Mailing Address - Country:US
Mailing Address - Phone:713-995-1202
Mailing Address - Fax:713-995-5743
Practice Address - Street 1:7737 SOUTHWEST FREEWAY
Practice Address - Street 2:#830
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074
Practice Address - Country:US
Practice Address - Phone:713-995-1202
Practice Address - Fax:713-995-5143
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2011-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG2399208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
C17420Medicare UPIN