Individual
MR. ALFREDO JIMENEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
18100 ST. JOHN DRIVE, SUITE 240, HOUSTON, TX 77058-0451
(281) 335-7755
(281) 335-7766
Mailing address
18100 ST. JOHN DRIVE, SUITE 240, HOUSTON, TX 77058-0451
(281) 335-7755
(281) 335-7766
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
J4653
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0029KV
BLUE CROSS/BLUE SHIELD
TX
05
—
045240103
—
TX
05
—
045240104
—
TX
01
—
10023864
AMERIGROUP
TX
01
—
163317401
MEDICAID
TX
01
—
8K6340
BLUE CROSS/BLUE SHIELD
TX
Enumeration date
06/14/2005
Last updated
08/31/2017
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