Provider Demographics
NPI:1861598971
Name:WASHINGTON, JEROME T (MD)
Entity type:Individual
Prefix:DR
First Name:JEROME
Middle Name:T
Last Name:WASHINGTON
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Gender:M
Credentials:MD
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Mailing Address - Street 1:7922 EWING HALSELL DR
Mailing Address - Street 2:STE 170
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3724
Mailing Address - Country:US
Mailing Address - Phone:210-614-5665
Mailing Address - Fax:210-868-6170
Practice Address - Street 1:7922 EWING HALSELL DR
Practice Address - Street 2:170
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3786
Practice Address - Country:US
Practice Address - Phone:210-614-5665
Practice Address - Fax:210-868-6170
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2021-09-30
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Provider Licenses
StateLicense IDTaxonomies
TXG1313207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
00GS65Medicare PIN
TXC23193Medicare UPIN