Individual provider Active NPI

Fernando M Jumalon, MD

  • Internal Medicine Physician
  • Houston, TX
National Provider Identifier
1700846201
Registry record updated Jul 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
K4094 Issued in TX
Practice address
4423 Griggs Rd
Houston, TX 77021-2815
Phone
(713) 429-0655
Fax
(713) 429-0670
NPI assigned
Mar 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X K4094 TX Primary

Addresses

Primary practice location

4423 Griggs Rd
Houston, TX 77021-2815

Mailing address

4423 Griggs Rd
Houston, TX 77021-2815
Phone (713) 429-0655

Other identifiers 1

IdentifierTypeStateIssuer
50459538MedicaidNM

Medicare participation

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
K4094TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dedicated Physicians Group of Texas PLLC Internal Medicine CurrentSince Mar 1, 2023 Accepting new patients
Presbyterian Healthcare Services Internal Medicine CurrentSince Jan 15, 2007 Accepting new patients
Presbyterian Healthcare Services Family Medicine CurrentSince Jan 15, 2007 Accepting new patients
Dedicated Physicians Group of Texas, PLLC CurrentSince Jul 16, 2023 Accepting new patients
Wvupc Medicine Clinic (Lab) Past Accepting new patients
Dedicated Physicians Group of Texas, PLLC PastSince Feb 7, 2021 Accepting new patients

Locations

8300 Constitution Ave NE
Bldg D
Albuquerque, NM 87110
Phone (505) 291-2200

1100 Central Ave SE
Albuquerque, NM 87106
Phone (505) 724-6124

1100 Central Ave SE
Fl 4
Albuquerque, NM 87106
Phone (505) 724-6124

8300 Constitution Ave NE
Albuquerque, NM 87110
Phone (505) 291-2000

2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577

4423 Griggs Rd
Houston, TX 77021
Phone (713) 429-0655

8471 Gulf Fwy
Houston, TX 77017
Phone (314) 390-5433

8121 Broadway St
Ste 150
Houston, TX 77061
Phone (832) 709-2770

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1143417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689292800000",
    "number": "1700846201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4423 GRIGGS RD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770212815",
            "telephone_number": "713-429-0655",
            "fax_number": "713-429-0670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4423 GRIGGS RD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770212815",
            "telephone_number": "713-429-0655",
            "fax_number": "713-429-0670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUMALON",
        "first_name": "FERNANDO",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-27",
        "last_updated": "2023-07-14",
        "certification_date": "2023-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "K4094",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "50459538",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.