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NPI Code Detail

MEDICARE: DR. LESAJEAN M JENNINGS PSY.D.

MEDICARE: DR. LESAJEAN M JENNINGS PSY.D.
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
1103TC0700XClinical Psychologist25562TX
2103TS0200XSchool Psychologist30396TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1245300706
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LESAJEAN M JENNINGS PSY.D.
Provider Business Mailing Address
First Line : 3938 LUCA ST
Second Line :
City : HOUSTON
State : TX
Zip : 77021-4022
Country : US
Telephone Number : 713-747-8136
Fax Number :
Provider Business Practice Location Address
First Line : 1319 LIVE OAK ST
Second Line :
City : HOUSTON
State : TX
Zip : 77003-4408
Country : US
Telephone Number : 713-225-2280
Fax Number : 713-225-5787
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/09/2006
Last Update Date : 09/11/2025

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