Look up the most recent NPI and PECOS records

Jg Nutrend Providers Pa

Family Medicine

Allopathic & Osteopathic Physicians

425 Holderrieth Blvd Ste 212, Tomball, TX 77375-4552

PECOS Enrollment

Based on the most recent information from CMS, provider Jg Nutrend Providers Pa does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1578185500
Provider Type
Organization
Full Name
Jg Nutrend Providers Pa

Subpart
No
Enumeration Date
5/13/2020
Last Updated
3/31/2021

Contact Information

Practice Location

425 Holderrieth Blvd Ste 212, Tomball, TX 77375-4552

(346) 246-4171

Unlisted Fax

Mailing Location

PO Box 27095, Belfast, ME 04915-2022

(346) 246-4171

Unlisted Fax

Authorized Official

Whitmeyer, Mary Nan (Practice Manager)

(346) 246-3424

Provider Taxonomies

Code	Description	License
Code 207Q00000X Primary	Description Family Medicine Allopathic & Osteopathic Physicians	License Unlisted Issuer
Code 261QA0005X	Description Clinic/Center Ambulatory Health Care Facilities	License Unlisted Issuer

Jg Nutrend Providers Pa

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Authorized Official

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Murillo, George J

Rolon, Sam Edwin

Lemon-Aid Medical Management

Liang, Irena

Texas Lone Star Family Medicine, P.A.

Huynh, Hung C

G A Valdez & Associates Inc

Zahiruddin, Shaukath

Texas Family Medicine Center, Pa

Heatly, Kristy D.