Individual
JACQUELINE R CARRUTHERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
600 N SAM HOUSTON PKWY W STE 650, HOUSTON, TX 77067-4336
(281) 654-4500
(281) 654-4501
Mailing address
600 N SAM HOUSTON PKWY W STE 650, HOUSTON, TX 77067-4336
(281) 654-4500
(281) 654-4501
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
K7429
TX
207R00000X
Internal Medicine Physician
Primary
K7429
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
152259103
—
TX
Enumeration date
08/02/2005
Last updated
07/05/2024
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