Provider Demographics
NPI:1588783575
Name:CUKIER, JEAN (M D)
Entity type:Individual
Prefix:
First Name:JEAN
Middle Name:
Last Name:CUKIER
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7400 FANNIN ST
Mailing Address - Street 2:1280
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-1920
Mailing Address - Country:US
Mailing Address - Phone:713-791-1400
Mailing Address - Fax:713-791-1470
Practice Address - Street 1:7400 FANNIN ST
Practice Address - Street 2:1280
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-1920
Practice Address - Country:US
Practice Address - Phone:713-791-1400
Practice Address - Fax:713-791-1470
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG0684174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXB22069Medicare UPIN