DR. JERRY LEE GENTRY II (NPI# 1750477683) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750477683 |
| Entity Type | Individual |
| Full Name | DR. JERRY LEE GENTRY II |
| Credential | MD |
| Practice Address |
5514 Atascocita Rd Suite 290 Humble TX 77346-2968 |
| Practice Telephone | 7134003038 |
| Practice Fax Number | 8326445597 |
| Mailing Telephone | 7134003038 |
| Mailing Fax Number | 8326445597 |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2016-10-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | N8918 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 00118334 | 05 | |
| MS | CIGNA PIN | 9805166 | 01 |
| Street Address |
5514 ATASCOCITA RD SUITE 290 |
| City | HUMBLE |
| State | TX |
| Zip Code | 77346-2968 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457308306 | Vision Source - Atascocita, P.a. | Optometrist | 5514 Atascocita Rd, Suite 100, Humble, TX 77346-2837 | 2006-05-27 |
| 1245680255 | Relief Pain and Wellness | Internal Medicine | 5514 Atascocita Rd, Ste 290, Humble, TX 77346-2968 | 2016-06-21 |
| 1194123943 | Tiffany Cee Turner | Optometrist | 5514 Atascocita Rd, #100, Humble, TX 77346-2968 | 2014-12-10 |
| 1336484088 | Michelle Y Howze | Physical Therapist | 5514 Atascocita Rd, Suite 160, Humble, TX 77346-2968 | 2012-12-06 |
| 1073857892 | Amie G Inamdar | Physical Therapist | 5514 Atascocita Rd, Suite 160, Humble, TX 77346-2968 | 2012-11-16 |
| 1538452024 | Lake Houston Asthma Allergy Immunology | Clinic/Center | 5514 Atascocita Rd, Humble, TX 77346-2968 | 2011-05-17 |
| 1932430162 | Kathleen Allys Wood | Physical Therapy Assistant | 5514 Atascocita Rd, Suite 160, Humble, TX 77346-2968 | 2010-01-28 |
| 1457595175 | Theraworks Inc | Clinic/Center | 5514 Atascocita Rd, Ste 160, Humble, TX 77346-2968 | 2009-04-24 |
| 1194762823 | William Gregg Simpson | Optometrist | 5514 Atascocita Rd, Suite 100, Humble, TX 77346-2837 | 2006-06-01 |
| 1962449694 | Janet Lee Terry | Optometrist | 5514 Atascocita Rd, Suite 100, Humble, TX 77346-2837 | 2006-06-01 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194336024 | Chandler Dejean | Dentist | 7315 Farm To Market 1960 Rd E, Humble, TX 77346 | 2020-08-13 |
| 1184275281 | Lakeshia Williams | Technician | 7419 Auburn Oak Trail, Humble, TX 77346 | 2019-09-20 |
| 1720557275 | Soh of Texas Samson Liu Pllc | Dentist | Fm 1960 #204, Humble, TX 77346 | 2018-11-14 |
| 1548774979 | Cvs Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 17900 West Lake Houston Highway, Houston, TX 77346 | 2017-11-21 |
| 1194267187 | Family Ties Living Center | Clinic/Center | 18707 Timbers Trace Drive, Humble, TX 77346 | 2016-11-08 |
| 1992254809 | Adam Thomas Huval | Registered Nurse | 20440 Us-59 #500, Humble, TX 77346 | 2016-10-03 |
| 1770953408 | Alliance Mri Lake Houston, LLC | Clinic/Center | 5514 Atascocita Road, Suite 180, Humble, TX 77346 | 2015-10-07 |
| 1740670975 | Ayesha Mohiuddin | Pediatrics | 17903 W Lake Houston Pkwy Ste 202, Atascocita, TX 77346 | 2015-01-26 |
| 1124422415 | Christopher Roath | Behavioral Analyst | 5364 Farm To Market 1960 Rd E, Humble, TX 77346 | 2014-10-15 |
| 1982004099 | Kimberly Fulghum | Registered Nurse | 19406 Texas Laurel Trl, Humble, TX 77346 | 2014-08-26 |
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| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669809190 | Swcw, Inc. | General Practice | 9802 Fm 1960 Rd W Suite 250, Humble, TX 77338 | 2013-09-30 |
| 1447573571 | Katie Thurman | General Practice | 20713 Aldine Westfield Rd, Humble, TX 77338-3317 | 2010-03-03 |
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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.