Provider Demographics
NPI:1336197623
Name:JONES, PETER HOWARD (MD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:HOWARD
Last Name:JONES
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 1:6565 FANNIN ST
Mailing Address - Street 2:A601
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2703
Mailing Address - Country:US
Mailing Address - Phone:713-790-5800
Mailing Address - Fax:713-798-7885
Practice Address - Street 1:6565 FANNIN ST
Practice Address - Street 2:A601
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2703
Practice Address - Country:US
Practice Address - Phone:713-790-5800
Practice Address - Fax:713-798-7885
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE8600207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX123856003Medicaid
TX123856001Medicaid
TX80X634Medicare PIN
TXD66689Medicare UPIN