Provider Demographics
NPI:1629826508
Name:HATTERY, JADEN LEA (MD)
Entity type:Individual
Prefix:
First Name:JADEN
Middle Name:LEA
Last Name:HATTERY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JADEN
Other - Middle Name:LEA
Other - Last Name:MOORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6431 FANNIN ST STE JJL 270
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-1501
Mailing Address - Country:US
Mailing Address - Phone:713-500-7882
Mailing Address - Fax:713-500-0758
Practice Address - Street 1:6431 FANNIN ST STE JJL 270
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-1501
Practice Address - Country:US
Practice Address - Phone:713-500-7882
Practice Address - Fax:713-500-0758
Is Sole Proprietor?:No
Enumeration Date:2024-05-07
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program