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General NPI Number Information
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NPI Number | 1518353192
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Entity Type | Individual
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Provider Name | JESUS ALFREDO CORREA M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/10/2015
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Last Update Date | 06/19/2025
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Provider Practice Location Address
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Address Line | 2801 FRANCISCAN DR
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City | BRYAN
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State | TX
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Zip | 77802-2544
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Country | US
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Telephone | 979-776-5967
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Fax | 979-731-5916
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Provider Business Mailing Address
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Address Line | 2800 S TEXAS AVE STE 202
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City | BRYAN
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State | TX
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Zip | 77802-5361
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Country | US
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Telephone | 979-680-5474
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Fax | 979-680-5478
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | D0089143
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | MD.61122723
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | D0089143
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License Number State | MD
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Taxonomy #4
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | S2750
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License Number State | TX
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