MEDICARE: MYRTLE K JEROUDI, MD, PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084S0012X	Sleep Medicine (Psychiatry & Neurology) Physician

General Provider Information

NPI Number	:	1093669244
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MYRTLE K JEROUDI, MD, PA

Provider Business Mailing Address
First Line	:	10942 BEINHORN RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77024-4518
Country	:	US
Telephone Number	:	210-865-5147
Fax Number	:

Provider Business Practice Location Address
First Line	:	10942 BEINHORN RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77024-4518
Country	:	US
Telephone Number	:	210-865-5147
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MYRTLE KARAM JEROUDI
Credential	:	MD
Telephone Number	:	210-865-5147

Provider Enumeration Date	:	02/24/2026
Last Update Date	:	02/24/2026

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