Provider Demographics
NPI:1649236415
Name:SETHNA, JERRI P (MD)
Entity type:Individual
Prefix:
First Name:JERRI
Middle Name:P
Last Name:SETHNA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:17115 RED OAK DR STE 220
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77090-2607
Mailing Address - Country:US
Mailing Address - Phone:281-397-0200
Mailing Address - Fax:281-397-0328
Practice Address - Street 1:17115 RED OAK DR STE 220
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-2607
Practice Address - Country:US
Practice Address - Phone:281-397-0200
Practice Address - Fax:281-397-0328
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-21
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH35232084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX128369901Medicaid
TX000000J34NOtherBLUE CROSS
P21629Medicare UPIN