Provider Demographics
NPI:1669472288
Name:WALKES, JON-CECIL MARTIN (MD)
Entity Type:Individual
Prefix:DR
First Name:JON-CECIL
Middle Name:MARTIN
Last Name:WALKES
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 1:25511 BUDDE RD STE 2502
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-2388
Mailing Address - Country:US
Mailing Address - Phone:281-888-0809
Mailing Address - Fax:877-559-7682
Practice Address - Street 1:1315 ST JOSEPH PKWY STE 1107
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77002-8235
Practice Address - Country:US
Practice Address - Phone:281-888-0809
Practice Address - Fax:877-559-7682
Is Sole Proprietor?:No
Enumeration Date:2005-07-26
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL0955208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8A4327OtherBCBSTX
TX146518905Medicaid
TX8A4327OtherBCBSTX
TXP00690849Medicare PIN
TX315656YMCGMedicare PIN
TX146518905Medicaid