Provider Demographics
NPI:1760526099
Name:JACOMIDES, JENNY LEHMANN (MD)
Entity Type:Individual
Prefix:
First Name:JENNY
Middle Name:LEHMANN
Last Name:JACOMIDES
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 1:7700 CAT HOLLOW DR
Mailing Address - Street 2:UNIT 104
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681-5796
Mailing Address - Country:US
Mailing Address - Phone:512-733-5437
Mailing Address - Fax:512-244-1861
Practice Address - Street 1:7700 CAT HOLLOW DR
Practice Address - Street 2:UNIT 104
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-5796
Practice Address - Country:US
Practice Address - Phone:512-733-5437
Practice Address - Fax:512-244-1861
Is Sole Proprietor?:No
Enumeration Date:2007-02-19
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL1080208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics