Provider Demographics
NPI:1528142825
Name:WHITSETT, JEFFREY C (MD)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:C
Last Name:WHITSETT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1237 CAMPBELL RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77055-6453
Mailing Address - Country:US
Mailing Address - Phone:713-365-9099
Mailing Address - Fax:713-365-9356
Practice Address - Street 1:1237 CAMPBELL RD.
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055-6453
Practice Address - Country:US
Practice Address - Phone:713-365-9099
Practice Address - Fax:713-365-9356
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2014-03-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXH9177207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX180035734OtherRAILROAD MEDICARE
TX8842M0OtherBLUE CROSS BLUE SHIELD
TX180035734OtherRAILROAD MEDICARE
TX8842M0OtherBLUE CROSS BLUE SHIELD