Provider Demographics
NPI:1881283828
Name:ARRAMBIDE, JESUS ALBERTO
Entity type:Individual
Prefix:
First Name:JESUS
Middle Name:ALBERTO
Last Name:ARRAMBIDE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17383 FM 1372 RD
Mailing Address - Street 2:
Mailing Address - City:NORTH ZULCH
Mailing Address - State:TX
Mailing Address - Zip Code:77872-6831
Mailing Address - Country:US
Mailing Address - Phone:956-290-4319
Mailing Address - Fax:
Practice Address - Street 1:725 E VILLA MARIA RD STE 1300
Practice Address - Street 2:
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77802-5320
Practice Address - Country:US
Practice Address - Phone:979-822-1850
Practice Address - Fax:979-775-6872
Is Sole Proprietor?:No
Enumeration Date:2021-01-14
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX204988106H00000X
183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist