Provider Demographics
NPI:1639583388
Name:BUTCHER, JAMILA (DPM)
Entity Type:Individual
Prefix:DR
First Name:JAMILA
Middle Name:
Last Name:BUTCHER
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9800 CENTRE PKWY STE 550
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-8262
Mailing Address - Country:US
Mailing Address - Phone:281-500-8891
Mailing Address - Fax:812-688-1900
Practice Address - Street 1:9800 CENTRE PKWY STE 550
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-8262
Practice Address - Country:US
Practice Address - Phone:281-500-8891
Practice Address - Fax:281-688-1900
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-19
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0862213ES0103X
NYR93087390200000X
TX3064213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program