Provider Demographics
NPI:1710929690
Name:SAENZ, JESUS A (MD)
Entity Type:Individual
Prefix:
First Name:JESUS
Middle Name:A
Last Name:SAENZ
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 1:1415 NORTH LOOP W
Mailing Address - Street 2:SUITE 820
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008-1664
Mailing Address - Country:US
Mailing Address - Phone:713-861-8200
Mailing Address - Fax:713-861-8261
Practice Address - Street 1:1415 NORTH LOOP W
Practice Address - Street 2:SUITE 820
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-1664
Practice Address - Country:US
Practice Address - Phone:713-861-8200
Practice Address - Fax:713-861-8261
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL84932085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX175206503Medicaid
TX175206501Medicaid
TX175206502OtherCSHCN
TX8S7130OtherBCBS
TX175206502OtherCSHCN
TX8S7130OtherBCBS
TX175206501Medicaid
TXP00399438Medicare PIN
TX8G9296Medicare PIN