MEDICARE: DR. RAYMOND C JESS M.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
1	2083P0011X	Undersea and Hyperbaric Medicine (Preventive Medicine) Physician	D3282	TX
2	207V00000X	Obstetrics & Gynecology Physician	D3282	TX

General Provider Information

NPI Number	:	1336145390
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAYMOND C JESS M.D.

Provider Business Mailing Address
First Line	:	130 REDBUD ST
Second Line	:
City	:	LAKE JACKSON
State	:	TX
Zip	:	77566-4616
Country	:	US
Telephone Number	:	979-297-5168
Fax Number	:	979-297-0099

Provider Business Practice Location Address
First Line	:	130 REDBUD ST
Second Line	:
City	:	LAKE JACKSON
State	:	TX
Zip	:	77566-4616
Country	:	US
Telephone Number	:	979-297-5168
Fax Number	:	979-297-0099

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/23/2005
Last Update Date	:	04/12/2026

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