Provider Demographics
NPI:1700026457
Name:AMIRNENI, JYOTHSNA (MD)
Entity Type:Individual
Prefix:
First Name:JYOTHSNA
Middle Name:
Last Name:AMIRNENI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 FROSTWOOD DR STE 1.100
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-2301
Mailing Address - Country:US
Mailing Address - Phone:713-338-6353
Mailing Address - Fax:
Practice Address - Street 1:7600 BEECHNUT ST FL 8
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-4302
Practice Address - Country:US
Practice Address - Phone:713-456-5686
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-20
Last Update Date:2020-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP8838207R00000X, 208M00000X
PAMT193615207R00000X
TXMT193615208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine