Individual
JEAN BISMUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6550 FANNIN ST, SUITE 1401, HOUSTON, TX 77030-2717
(713) 441-5200
(713) 793-7428
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
M7050
TX
2086S0129X
Vascular Surgery Physician
Primary
ME164624
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1639330053
BLUE CROSS BLUE SHIELD
TX
05
—
197950201
—
TX
05
—
197950203
—
TX
05
—
197950204
—
TX
05
—
197950205
—
TX
01
—
8BC029
BCBS
TX
01
—
P01318687
RR MEDICARE
TX
Enumeration date
06/18/2008
Last updated
11/27/2023
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