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NPI Code Detail

MEDICARE: JESTY GEORGE NP

MEDICARE: JESTY GEORGE NP
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
1363LF0000XFamily Nurse Practitioner938121TX

General Provider Information

NPI Number : 1922633874
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESTY GEORGE NP
Provider Business Mailing Address
First Line : 16537 SOUTHWEST FWY STE 500
Second Line :
City : SUGAR LAND
State : TX
Zip : 77479-7244
Country : US
Telephone Number : 281-274-7595
Fax Number :
Provider Business Practice Location Address
First Line : 16537 SOUTHWEST FWY STE 500
Second Line :
City : SUGAR LAND
State : TX
Zip : 77479-7244
Country : US
Telephone Number : 281-274-7595
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/10/2020
Last Update Date : 06/17/2024

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