Provider Demographics
NPI:1730486986
Name:T JAYAKUMAR MD PA
Entity Type:Organization
Organization Name:T JAYAKUMAR MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THIRUMALAIRAJ
Authorized Official - Middle Name:
Authorized Official - Last Name:JAYAKUMAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-995-1202
Mailing Address - Street 1:7737 SOUTHWEST FWY
Mailing Address - Street 2:#830
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-1807
Mailing Address - Country:US
Mailing Address - Phone:713-995-1202
Mailing Address - Fax:713-995-5143
Practice Address - Street 1:7737 SOUTHWEST FWY
Practice Address - Street 2:#830
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-1807
Practice Address - Country:US
Practice Address - Phone:713-995-1202
Practice Address - Fax:713-995-5143
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-24
Last Update Date:2011-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG2399174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXC17420Medicare UPIN