MEDICARE: JAMES R JISTEL 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
1	207L00000X	Anesthesiology Physician	H0498	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	:	1053362640
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES R JISTEL M.D.

Provider Business Mailing Address
First Line	:	PO BOX 73265
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77273-3265
Country	:	US
Telephone Number	:	281-580-9030
Fax Number	:	281-580-2725

Provider Business Practice Location Address
First Line	:	1313 HERMANN DR
Second Line	:	SUITE 270
City	:	HOUSTON
State	:	TX
Zip	:	77004-7005
Country	:	US
Telephone Number	:	281-444-3681
Fax Number	:	281-580-2725

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

Provider Enumeration Date	:	05/16/2006
Last Update Date	:	10/19/2015

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Directions to “ JAMES R JISTEL M.D.” Practice Location

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