Individual provider Active NPI

Jerryce Hudson, M.D.

  • Family Medicine Physician
  • Pearland, TX
National Provider Identifier
1780097121
Registry record updated Jan 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
R1777 Issued in TX
Practice address
4320 Broadway St Ste 100
Pearland, TX 77581-4016
Phone
(281) 485-0334
Fax
(281) 485-3308
NPI assigned
Jun 3, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X R1777 TX Primary

Addresses

Primary practice location

4320 Broadway St Ste 100
Pearland, TX 77581-4016

Mailing address

4320 Broadway St Ste 100
Pearland, TX 77581-4016
Phone (281) 485-0334

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170627002687 TX Practitioner - Family Practice 9234422601 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Howard University College of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wangandjiang, MD, PAGroup PAC ID 0345236485, 13 clinicians

Practice addresses (Care Compare)

9999 Bellaire Blvd
Suite 370
Houston, TX 77036-3499
Phone (713) 270-0909

Hospital & facility affiliations

  • HCA Houston Healthcare Pearland Hospital, Pearland, TX, CCN 670106

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wang&Jiang, MD, PA Family Medicine CurrentSince Jun 9, 2017 Accepting new patients

Locations

16702 House Hahl Rd
Bldg 11
Cypress, TX 77433
Phone (281) 766-9669

9999 Bellaire Blvd
Ste 370
Houston, TX 77036
Phone (713) 270-0909

1500 S Dairy Ashford Rd
Ste 198
Houston, TX 77077
Phone (281) 759-0200

143 Bella Katy Dr
Katy, TX 77494
Phone (346) 387-9889

1600 W League City Pkwy
Ste M
League City, TX 77573
Phone (409) 299-5914

4320 Broadway St
Ste 100
Pearland, TX 77581
Phone (281) 485-0334

7830 W Grand Pkwy S
Ste 180
Richmond, TX 77406
Phone (281) 799-7180

210 Genesis Blvd
Ste A
Webster, TX 77598
Phone (281) 338-7693

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1401753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547769600000",
    "number": "1780097121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4320 BROADWAY ST STE 100",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775814016",
            "telephone_number": "281-485-0334",
            "fax_number": "281-485-3308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4320 BROADWAY ST STE 100",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775814016",
            "telephone_number": "281-485-0334",
            "fax_number": "281-485-3308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDSON",
        "first_name": "JERRYCE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-03",
        "last_updated": "2019-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "R1777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pearland, TX

Sources for this page

Verify at the official NPI Registry.