Russell, Jeanne M

Russell, Jeanne M is an individual health care provider with primary practice located at 17226 Mercury Dr Ste 100 , Houston TX 77058-2793. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Russell, Jeanne M can be contacted via phone (281) 975-0600.

Contact Information

Primary practice address
17226 Mercury Dr Ste 100 Houston TX 77058-2793
Fax: (281) 975-0601
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA00473 Texas

Profile Details

NPI number 1427026079
LBN Legal business name Russell, Jeanne M
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 9th, 2006
Last updated Jul 21st, 2022 - about 2 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1427026079 NPPES
Texas MEDICAID 207783602

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