Provider Demographics
NPI:1588922975
Name:JEROUDI, MYRTLE KARAM (MD)
Entity type:Individual
Prefix:
First Name:MYRTLE
Middle Name:KARAM
Last Name:JEROUDI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MYRTLE
Other - Middle Name:MARIE
Other - Last Name:KARAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12301 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77035-6207
Mailing Address - Country:US
Mailing Address - Phone:713-275-5120
Mailing Address - Fax:
Practice Address - Street 1:12301 MAIN ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77035-6207
Practice Address - Country:US
Practice Address - Phone:713-275-5324
Practice Address - Fax:713-275-5120
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-24
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR17842084S0012X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine