Individual provider Active NPI

Peter Selim Siyahhan Julnes, MD

  • Psychiatry Physician
  • Houston, TX
National Provider Identifier
1366068058
Registry record updated Sep 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
V2274 Issued in TX
Practice address
12301 Main St
Houston, TX 77035-6207
Phone
(713) 275-5350
NPI assigned
Jun 18, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 2022010400 MO
Psychiatry Physician 2084P0800X V2274 TX Primary

Addresses

Primary practice location

12301 Main St
Houston, TX 77035-6207

Mailing address

12301 Main St
Houston, TX 77035-6207
Phone (713) 275-5350

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200925002351 MO Order and Referring Only - PsychiatryPractitioner - Psychiatry 5890114706

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
V2274TXMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1592438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726099200000",
    "number": "1366068058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12301 MAIN ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770356207",
            "telephone_number": "713-275-5350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12301 MAIN ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770356207",
            "telephone_number": "713-275-5350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIYAHHAN JULNES",
        "first_name": "PETER SELIM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-18",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MO",
            "license": "2022010400",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "V2274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.