Individual
JAYNE M VIETS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1515 HOLCOMBE BLVD, HOUSTON, TX 77030-4009
(713) 792-6161
Mailing address
P O BOX 4439, HOUSTON, TX 77210-4439
(713) 792-2991
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
J9929
TX
208000000X
Pediatrics Physician
J9929
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00096V
BC/BS
TX
05
—
142691801
—
TN
05
—
142691802
—
TX
05
—
142691804
—
TX
05
—
142691810 (MDACC)
—
TX
01
—
76068407077068
TRICARE
TX
01
—
8BH650
BCBS (MDACC)
TX
01
—
8X6081
BCBS
TX
01
—
P00729519
RR MEDICARE (MDACC)
TX
Enumeration date
08/31/2006
Last updated
07/18/2012
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