Provider Demographics
NPI:1811133697
Name:DARCOURT, JORGE GERMAN (MD)
Entity type:Individual
Prefix:
First Name:JORGE
Middle Name:GERMAN
Last Name:DARCOURT
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 1:16659 SOUTHWEST FWY
Mailing Address - Street 2:SUITE 151
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-2375
Mailing Address - Country:US
Mailing Address - Phone:281-276-5200
Mailing Address - Fax:281-276-5201
Practice Address - Street 1:16659 SOUTHWEST FWY
Practice Address - Street 2:SUITE 151
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-2375
Practice Address - Country:US
Practice Address - Phone:281-276-5200
Practice Address - Fax:281-276-5201
Is Sole Proprietor?:No
Enumeration Date:2008-12-27
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM4751207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX204293904Medicaid
TX8L14250OtherMEDICARE PTAN
TX1811133697OtherBLUE CROSS BLUE SHIELD
TXP01120352OtherRR MEDICARE
TX204293903Medicaid
TX204293903Medicaid
TX342852YMVQMedicare PIN
TX342852YQ64Medicare PIN
TX8L14250OtherMEDICARE PTAN