Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | 2377 | TX |
N | 222Z00000X | Podiatrist | 2377 | TX |
Y | 213ES0103X | Foot & Ankle Surgery | 2377 | TX |
NPI | 1023467867 |
---|---|
Provider Name | Dr. Kent T. Jarvis |
First Address | Humble, TX 77338-4404 |
Second Address | Humble, TX 77338-4404 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2016 |
Last Update Date | 02/02/2022 |