Provider Demographics
NPI:1851395800
Name:DUFFY, JENNIE ANN OZOG (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNIE
Middle Name:ANN OZOG
Last Name:DUFFY
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 1:6560 FANNIN ST STE 1720
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2735
Mailing Address - Country:US
Mailing Address - Phone:713-790-0058
Mailing Address - Fax:713-790-0410
Practice Address - Street 1:6560 FANNIN ST STE 1720
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2735
Practice Address - Country:US
Practice Address - Phone:713-790-0058
Practice Address - Fax:713-790-0410
Is Sole Proprietor?:No
Enumeration Date:2005-06-08
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF1516207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX40048233OtherDPS
TX40048233OtherDPS
TX40048233OtherDPS
8G1974Medicare ID - Type Unspecified
AD1814400OtherDEA