Jilly Kunjunny Vidyasagaran, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

J2829 Issued in TX

Practice address

4024 Brookhaven Ave
Pasadena, TX 77504-1902

Phone

(713) 944-2324

Fax

(713) 944-1539

NPI assigned

Apr 25, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Fairmont Childrens PLLC

  • Pediatrics Physician
  • Pasadena, TX
  • NPI 1033778170
  NPD
• Fairmont Pediatrics and Associates

  • Pediatrics Physician
  • Pasadena, TX
  • NPI 1144405762
  NPD (past)

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322524800000",
    "number": "1629034103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4024 BROOKHAVEN AVE",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775041902",
            "telephone_number": "713-944-2324",
            "fax_number": "713-944-1539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4024 BROOKHAVEN AVE",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775041902",
            "telephone_number": "713-944-2324",
            "fax_number": "713-944-1539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIDYASAGARAN",
        "first_name": "JILLY",
        "middle_name": "KUNJUNNY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-25",
        "last_updated": "2011-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "J2829",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THSTEPS",
            "identifier": "1270928-05",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1270928-03",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lilia Vera
• Manuel Vera, PHARMD
• Glynda Verde
• Sarfraz Verjee, DDS
• Katie J Vichensont, APRN-CNP
• Villa and Serna Inc.
• Jeanette Villagomez, MA, CFY-SLP
• Joy Danielle Villarreal, M.A., L.P.C.
• Melany Villarreal, LMSW
• Jordan Vincent, PT, DPT

• Pediatrics Physician in Pasadena, TX
• Providers in Pasadena, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2011; 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.