Provider Demographics
NPI:1063616647
Name:MIDDLETON, JAIME JENEE (MD)
Entity type:Individual
Prefix:DR
First Name:JAIME
Middle Name:JENEE
Last Name:MIDDLETON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 890213
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77289
Mailing Address - Country:US
Mailing Address - Phone:281-480-7832
Mailing Address - Fax:832-615-1110
Practice Address - Street 1:10970 SHADOW CREEK PKWY
Practice Address - Street 2:SUITE NUMBER 250
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-0100
Practice Address - Country:US
Practice Address - Phone:832-615-1109
Practice Address - Fax:832-615-1110
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-14
Last Update Date:2016-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP4354207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP4354OtherTEXAS LICENSE
LA1339890Medicaid
TXP4354OtherTEXAS LICENSE
TXP4354OtherTEXAS LICENSE