Individual
DR. JASON EVERETT DECKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2017 BROADWAY ST, PEARLAND, TX 77581-5501
(281) 485-9990
(281) 485-9469
Mailing address
2017 BROADWAY ST, PEARLAND, TX 77581-5501
(281) 485-9990
(281) 485-9469
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
L1558
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
145224503
MEDICAID PROVIDER ID
TX
01
—
L1558
LICENSE NUMBER
TX
Enumeration date
10/04/2005
Last updated
05/23/2008
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