Provider Demographics
NPI:1134369960
Name:JALOWY, JEFFREY ALAN (DDS)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:ALAN
Last Name:JALOWY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 928
Mailing Address - Street 2:
Mailing Address - City:EAST BERNARD
Mailing Address - State:TX
Mailing Address - Zip Code:77435-0928
Mailing Address - Country:US
Mailing Address - Phone:979-335-4825
Mailing Address - Fax:979-335-6076
Practice Address - Street 1:901 CLUBSIDE DRIVE
Practice Address - Street 2:
Practice Address - City:EAST BERNARD
Practice Address - State:TX
Practice Address - Zip Code:77435-0928
Practice Address - Country:US
Practice Address - Phone:979-335-4825
Practice Address - Fax:979-335-6076
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-06
Last Update Date:2009-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16510122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist