Healthcare Provider Details

I. General information

NPI: 1992266043
Provider Name (Legal Business Name): JARED OURIEFF DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/29/2019
Last Update Date: 04/15/2025
Certification Date: 04/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6431 FANNIN ST
HOUSTON TX
77030-1501
US

IV. Provider business mailing address

1040 RIDGECREST PL
NIPOMO CA
93444-9404
US

V. Phone/Fax

Practice location:
  • Phone: 713-704-4000
  • Fax:
Mailing address:
  • Phone: 805-720-5455
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberU9622
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: