Jefferson, Larry
Jefferson, Larry is an individual health care provider with primary practice located at 6621 Fannin St Wt 6-006, Houston TX 77030-2316. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatric Pulmonology, Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine. Allopathic & Osteopathic Physicians / Pediatric Pulmonology is his primary health care specialty. Jefferson, Larry can be contacted via phone (832) 824-6230.Contact Information
Primary practice address
6621 Fannin St Wt 6-006
Houston TX 77030-2316
Phone: (832) 824-6230
Fax: (832) 825-2967
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatric Pulmonology | 2080P0214X | G2400 | Texas |
| Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine | 2080P0203X | G2400 | Texas |
Profile Details
| NPI number | 1083794341 |
|---|---|
| LBN Legal business name | Jefferson, Larry |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 17th, 2006 |
| Last updated | Sep 17th, 2015 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1083794341 | NPPES |
| Texas | MEDICAID | 134850003 |
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