Provider Demographics
NPI:1700967080
Name:FINKELSTEIN, JEREMY P (MD)
Entity Type:Individual
Prefix:
First Name:JEREMY
Middle Name:P
Last Name:FINKELSTEIN
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:PO BOX 24125
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76124-1125
Mailing Address - Country:US
Mailing Address - Phone:817-451-4208
Mailing Address - Fax:
Practice Address - Street 1:6565 FANNIN ST
Practice Address - Street 2:SUITE M 196
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2703
Practice Address - Country:US
Practice Address - Phone:713-441-4467
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ8535207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00204525OtherRAILROAD MEDICARE
TX8P5335OtherBLUE CROSS BLUE SHIELD
TX165688602Medicaid
TX165688603Medicaid
TX8P5335OtherBLUE CROSS & BLUE SHIELD
TX8D2001Medicare PIN
TX8P5335OtherBLUE CROSS & BLUE SHIELD
TXG30678Medicare UPIN
TX8C2732Medicare PIN