Provider Demographics
NPI:1689727257
Name:MAYOR, JESUS JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JESUS
Middle Name:
Last Name:MAYOR
Suffix:JR
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 1:302 W GULF BANK RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77037-2325
Mailing Address - Country:US
Mailing Address - Phone:281-447-7614
Mailing Address - Fax:281-447-6549
Practice Address - Street 1:302 W GULF BANK RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77037-2325
Practice Address - Country:US
Practice Address - Phone:281-447-7614
Practice Address - Fax:281-447-6549
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH3116207Q00000X
TXH-3116208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8Z1587OtherBC BS PPO
TX126942504OtherTHSTEP
TX126942501Medicaid
TX26285OtherAMERIGROUP
TXE0066996OtherDPS
TX760528198OtherTAX ID
TX1024606OtherAETNA
TX1024606OtherAETNA
TX8Z1587OtherBC BS PPO
TX126942501Medicaid