MEDICARE: DR. JANTZEN DEANDRE THORNS I 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	208600000X	Surgery Physician	R0511	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	:	1972881100
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JANTZEN DEANDRE THORNS I M.D.

Provider Business Mailing Address
First Line	:	20207 CHASEWOOD PARK DR STE 305
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77070-1442
Country	:	US
Telephone Number	:	832-534-7600
Fax Number	:

Provider Business Practice Location Address
First Line	:	20207 CHASEWOOD PARK DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77070-1441
Country	:	US
Telephone Number	:	832-534-7600
Fax Number	:

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

Provider Enumeration Date	:	07/21/2011
Last Update Date	:	10/09/2024

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Directions to “ DR. JANTZEN DEANDRE THORNS I M.D.” Practice Location

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