Provider Demographics
NPI:1124254784
Name:GROUNDS, JILL (MD)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:
Last Name:GROUNDS
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 1:3345 PLAZA 10 DR STE E
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77707-2553
Mailing Address - Country:US
Mailing Address - Phone:409-838-2626
Mailing Address - Fax:409-838-1980
Practice Address - Street 1:9180 PINECROFT DR STE 400
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77380-3899
Practice Address - Country:US
Practice Address - Phone:713-897-7221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-09
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP8478207R00000X, 207RC0000X, 207RI0011X
MA240946207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease