MEDICARE: NAMIETA MODY JANSSEN 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	207RR0500X	Rheumatology Physician	H7619	TX

General Provider Information

NPI Number	:	1609979947
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NAMIETA MODY JANSSEN M.D.

Provider Business Mailing Address
First Line	:	1327 LAKE POINTE PKWY STE 325
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77478-4097
Country	:	US
Telephone Number	:	832-500-5002
Fax Number	:	832-500-5011

Provider Business Practice Location Address
First Line	:	1327 LAKE POINTE PKWY STE 325
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77478-4097
Country	:	US
Telephone Number	:	832-500-5002
Fax Number	:	832-500-5011

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

Provider Enumeration Date	:	09/05/2006
Last Update Date	:	03/25/2025

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