Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 539241 | TX |
N | 111NI0900X | Internist | 539241 | TX |
Y | 207RI0200X | Infectious Disease | P5494 | TX |
N | 2080P0208X | Pediatric Infectious Diseases | P5494 | TX |
NPI | 1265767685 |
---|---|
Provider Name | Jill Elizabeth Weatherhead |
First Address | Houston, TX 77030-3411 |
Second Address | Houston, TX 77030-3411 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2009 |
Last Update Date | 15/09/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P5494 | TEXAS MEDICAL BOARD (01) | TX |