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Jeremy Ryan Walder

Internal Medicine

Allopathic & Osteopathic Physicians

PECOS Enrollment

This provider is enrolled in PECOS as JEREMY WALDER.

Based on the most recent information from CMS, provider Jeremy Ryan Walder is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 8:41 AM.

Profile Details

Provider ID
1124524103
Provider Type
Individual
Full Name
Walder, Jeremy Ryan
Title
Dr.
Credential
DO

Gender
Male
Sole Proprietor
No
Enumeration Date
3/30/2018
Last Updated
6/28/2024

Contact Information

Practice Location

6431 Fannin St, Houston, TX 77030-1501

(713) 500-6500

Unlisted Fax

Mailing Location

6431 Fannin St, Houston, TX 77030-1501

(713) 500-6500

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207RP1001X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License U3687 Texas
Code 207RC0200X	Description Internal Medicine Allopathic & Osteopathic Physicians	License U3687 Texas

Jeremy Ryan Walder

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Lodato, Robert F

Mathew, Reeba

Almoosa, Khalid F

Taitano, Matthew Minoru

Onn, Amir

Sabath, Bruce Fernando

Jimenez, Carlos A.

Santacruz, Jose Fernando

Colomer, Alberto Luis

Beshay, Sarah