Provider Demographics
NPI:1679611156
Name:JONES, GERALDINE
Entity type:Individual
Prefix:MRS
First Name:GERALDINE
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:GERALDINE
Other - Middle Name:
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:6639 CRESTMONT ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77033-1034
Mailing Address - Country:US
Mailing Address - Phone:713-643-2529
Mailing Address - Fax:713-643-2529
Practice Address - Street 1:5202 RIDGEWAY DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77033-2834
Practice Address - Country:US
Practice Address - Phone:713-733-6173
Practice Address - Fax:713-643-2529
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX118910171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor