Individual
JIMMY KIDARATHIL GEORGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
301 UNIVERSITY BLVD, GALVESTON, TX 77555-7634
(409) 747-2849
Mailing address
301 UNIVERSITY BLVD, GALVESTON, TX 77555-5303
(409) 747-2849
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
BP10080736
TX
2085R0202X
Diagnostic Radiology Physician
Primary
BP20090009
TX
Other
Enumeration date
05/10/2022
Last updated
06/06/2024
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