Healthcare Provider Details

I. General information

NPI: 1861589806
Provider Name (Legal Business Name): CLAUDEL DUCLOS JEAN-PIERRE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 10/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22999 HIGHWAY 59 N SUITE 201
KINGWOOD TX
77339-4412
US

IV. Provider business mailing address

PO BOX 890213
HOUSTON TX
77289-0213
US

V. Phone/Fax

Practice location:
  • Phone: 832-615-1107
  • Fax: 832-615-1108
Mailing address:
  • Phone: 281-480-7832
  • Fax: 281-480-7504

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number220257
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License NumberM7306
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number35092170
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: