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NPI Code Detail

MEDICARE: JEAN R JOSEPH-VANDERPOOL M.D.

MEDICARE: JEAN R JOSEPH-VANDERPOOL 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
12084P0800XPsychiatry PhysicianH8699TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
22084P0800XOTHERTAXONOMY PSYCHIATRY
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4251B00000XOTHERTAXONOMY CASE MANAGEMENT
5193200000XOTHERTAXONOMY MULTISPECIALTY
6MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7193400000XOTHERTAXONOMY SINGLE SPECIALTY

General Provider Information

NPI Number : 1659451565
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEAN R JOSEPH-VANDERPOOL M.D.
Provider Business Mailing Address
First Line : 6028 SURETY DR
Second Line : BUILDING 13
City : EL PASO
State : TX
Zip : 79905-7934
Country : US
Telephone Number : 915-544-3500
Fax Number : 915-532-4433
Provider Business Practice Location Address
First Line : 6028 SURETY DR
Second Line :
City : EL PASO
State : TX
Zip : 79905-2018
Country : US
Telephone Number : 915-544-3500
Fax Number : 915-532-4433
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/16/2006
Last Update Date : 01/11/2023

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