Provider Demographics
NPI:1356412084
Name:OEY, JAMIE CARISSA (MD)
Entity type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:CARISSA
Last Name:OEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JANTI
Other - Middle Name:DHARMA
Other - Last Name:OEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4112 LINKS LN STE 102
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78664-3902
Mailing Address - Country:US
Mailing Address - Phone:512-436-9455
Mailing Address - Fax:512-436-9447
Practice Address - Street 1:4112 LINKS LN STE 102
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664-3902
Practice Address - Country:US
Practice Address - Phone:512-436-9455
Practice Address - Fax:512-436-9447
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2019-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ1697208000000X
CAA53553174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No174400000XOther Service ProvidersSpecialist