Individual provider Active NPI

Jiji Balu Zachariah, NURSE PRACTITIONER

  • Primary Care Nurse Practitioner
  • Houston, TX
National Provider Identifier
1043748759
Registry record updated May 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
AP132589 Issued in TX
Practice address
4141 Southwest Fwy
Houston, TX 77027-7313
Phone
(713) 662-0217
NPI assigned
May 24, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X AP132589 TX Primary

Addresses

Primary practice location

4141 Southwest Fwy
Houston, TX 77027-7313

Mailing address

11435 English Rose TRL
Missouri City, TX 77459-7069

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP132589TXMDPrimary Care Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1495584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1495584000000",
    "number": "1043748759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11435 ENGLISH ROSE TRL",
            "city": "MISSOURI CITY",
            "state": "TX",
            "postal_code": "774597069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4141 SOUTHWEST FWY",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770277313",
            "telephone_number": "713-662-0217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZACHARIAH",
        "first_name": "JIJI",
        "middle_name": "BALU",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-24",
        "last_updated": "2017-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TX",
            "license": "AP132589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.