Provider Demographics
NPI:1881672103
Name:JEROUDI, MOHAMED O (MD)
Entity Type:Individual
Prefix:DR
First Name:MOHAMED
Middle Name:O
Last Name:JEROUDI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5060 CRENSHAW RD
Mailing Address - Street 2:STE 200
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77505-3146
Mailing Address - Country:US
Mailing Address - Phone:832-230-3379
Mailing Address - Fax:832-230-3724
Practice Address - Street 1:5060 CRENSHAW RD
Practice Address - Street 2:SUITE 200
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77505-3145
Practice Address - Country:US
Practice Address - Phone:832-230-3379
Practice Address - Fax:832-230-3724
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-06
Last Update Date:2017-07-24
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Provider Licenses
StateLicense IDTaxonomies
TXJ1701207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease