Russell, Jonathan R.

Russell, Jonathan R. is an individual health care provider with primary practice located at 10130 Louetta Rd Suite G, Houston TX 77070-2118. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Obstetrics & Gynecology. Allopathic & Osteopathic Physicians / Obstetrics & Gynecology is his primary health care specialty. Russell, Jonathan R. can be contacted via phone (832) 698-5500.

Contact Information

Primary practice address
10130 Louetta Rd Suite G Houston TX 77070-2118
Phone: (832) 698-5500
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X L0557 Texas
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X L0557 Texas

Profile Details

NPI number 1336142553
LBN Legal business name Russell, Jonathan R.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 23rd, 2005
Last updated Aug 21st, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1336142553 NPPES
Texas Other 8FX325 BLUE CROSS BLUE SHIELD
Texas Other 1336142553 BLUE CROSS BLUE SHIELD
Texas MEDICAID 143751903 BLUE CROSS BLUE SHIELD
Texas MEDICAID 143751904 BLUE CROSS BLUE SHIELD

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