Individual
DR. JASON WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., PH.D.
Contact information
Practice address
1515 HOLCOMBE BLVD, HOUSTON, TX 77030-4000
(713) 792-6161
Mailing address
PO BOX 4439, HOUSTON, TX 77210-4439
(713) 792-2991
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
R6312
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
387864701
—
TX
01
—
387864702
MEDICAID CSHCN
TX
Enumeration date
04/10/2014
Last updated
02/11/2022
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