KRYSTAL LYNN JERRY (NPI# 1376833673) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376833673 |
| Entity Type | Individual |
| Full Name | KRYSTAL LYNN JERRY |
| Credential | MD |
| Practice Address |
490 Ih 10 N Ste 100 Beaumont TX 77702-1819 |
| Mailing Address |
122 W John Carpenter Fwy Ste 420 Irving TX 75039-2014 |
| Practice Telephone | 4092129988 |
| Mailing Telephone | 9729579300 |
| Enumeration Date | 2011-04-08 |
| Last Update Date | 2020-05-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | P9207 | TX | Allopathic & Osteopathic Physicians |
| Street Address |
490 IH 10 N STE 100 |
| City | BEAUMONT |
| State | TX |
| Zip Code | 77702-1819 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518957471 | Jorge Washington Black | Pediatrics | 490 Ih 10 N Ste 100, Beaumont, TX 77702-1819 | 2005-10-24 |
| 1699382978 | Young Ron Kim | Nurse Practitioner | 490 Ih 10 N Ste 100, Beaumont, TX 77702-1819 | 2020-09-30 |
| 1598144735 | Elizabeth Garcia | Pediatrics | 490 Ih 10 N Ste 100, Beaumont, TX 77702-1819 | 2015-05-20 |
| 1144635152 | Cheryl Smith | Nurse Practitioner | 490 Ih 10 N Ste 100, Beaumont, TX 77702-1819 | 2014-06-27 |
| 1245432038 | Krishnakumari Kanesan | Pediatrics | 490 Ih 10 N Ste 100, Beaumont, TX 77702-1819 | 2007-06-04 |
| 1184769812 | Tricia Lois Bullard | Nurse Practitioner | 490 Ih 10 N Ste 100, Beaumont, TX 77702-1819 | 2007-02-20 |
| 1104854322 | Barbara L Simon | Nurse Practitioner | 490 Ih 10 N Ste 100, Beaumont, TX 77702-1819 | 2006-06-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346871134 | Anne Parker Chen | Psychologist | 2431 Liberty St., Beaumont, TX 77702 | 2020-01-30 |
| 1841715299 | Encounter Home Care, Inc. | Home Health | 990 I H 10 North, 225, Beaumont, TX 77702 | 2017-08-07 |
| 1962860023 | Jennifer Abney Bell | Nurse Practitioner | 3030 North St., Suite 510, Beaumont, TX 77702 | 2016-02-04 |
| 1720407687 | Jennifer Huff | Nurse Practitioner | 2980 Calder Ave, Beaumont, TX 77702 | 2014-04-08 |
| 1669894580 | Julie Christine Makdsi | Psychologist | 80 Interstate 10 N., Suite 205, Beaumont, TX 77702 | 2014-01-11 |
| 1437586682 | Lori Wenner | Registered Nurse | 2410 Harrison Street, Beaumont, TX 77702 | 2013-10-02 |
| 1548503311 | Robert J Grammatico | Emergency Medicine | 2830 Calder Ave., Beaumont, TX 77702 | 2013-03-30 |
| 1396084992 | Courtney Marie Guidry | Physician Assistant | 755 N 11th St Ste P5200, Beaumont, TX 77702 | 2013-02-04 |
| 1043524788 | Swarnalatha Devi Bathina | Dentist | 490 Ih-10, Suite 200, Beaumont, TX 77702 | 2010-08-05 |
| 1376798884 | Rehana Haq Javed | Pathology | Christus Hospital 2830 Calder St., Beaumont, TX 77702 | 2008-11-25 |
| Find all providers in zip 77702 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396008280 | Robert Codey Bell | Pediatrics | 3560 Delaware St Ste 1202, Beaumont, TX 77706 | 2012-06-17 |
| 1154505295 | Raja Ataya M.d. | Pediatrics | 3070 College St # 302, Beaumont, TX 77701-4691 | 2007-12-26 |
| 1912189747 | Sharda J. Doshi, M.d.pa | Pediatrics | 2929 Calder Ave, Suite 300, Beaumont, TX 77702-1845 | 2007-12-04 |
| 1144393810 | Robert B Dundas Md Pa | Pediatrics | 810 Hospital Dr Ste 301, Beaumont, TX 77701-4635 | 2006-11-17 |
| 1700981164 | Joseph Parker Derrick Sr. | Pediatrics | 3480 Fannin Street, Ste D, Beaumont, TX 77701-3804 | 2006-09-13 |
| 1811902307 | Elias N Ezike | Pediatrics | 710 S 8th St Ste A, Beaumont, TX 77701-4680 | 2006-07-31 |
| 1245200781 | Shahid I Rafiq | Pediatrics | 490 Ih 10 N, Ste # 100, Beaumont, TX 77702 | 2006-01-26 |
| 1831171792 | Carl J Hubbell | Pediatrics | 3127 College St, Beaumont, TX 77701-4609 | 2005-11-16 |
| 1518957471 | Jorge Washington Black | Pediatrics | 490 Ih 10 N Ste 100, Beaumont, TX 77702-1819 | 2005-10-24 |
| 1457355992 | Sharda J. Doshi | Pediatrics | 3455 Stagg Dr, Beaumont, TX 77701 | 2005-06-13 |
| Find all providers in BEAUMONT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.