MEDICARE: FERNANDO M JUMALON MD

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	207R00000X	Internal Medicine Physician	K4094	TX

Other Identifiers

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

General Provider Information

NPI Number	:	1700846201
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FERNANDO M JUMALON MD

Provider Business Mailing Address
First Line	:	4423 GRIGGS RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77021-2815
Country	:	US
Telephone Number	:	713-429-0655
Fax Number	:	713-429-0670

Provider Business Practice Location Address
First Line	:	4423 GRIGGS RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77021-2815
Country	:	US
Telephone Number	:	713-429-0655
Fax Number	:	713-429-0670

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

Provider Enumeration Date	:	03/27/2006
Last Update Date	:	07/14/2023

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