| Mitalee Jiva, | |
|
1890 Research Forest Dr, Shenandoah, TX 77381-4566 | |
| (832) 658-3600 | |
| (713) 897-7009 |
| Full Name | Mitalee Jiva |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 9 Years |
| Location | 1890 Research Forest Dr, Shenandoah, Texas |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023533080 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | AP134185 (Texas) | Primary |
| 363LF0000X | Nurse Practitioner - Family | 803122 (Texas) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Memorial Hermann Hospital System | Houston, TX | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Memorial Hermann Medical Group | 7012008360 | 674 |
| Entity Name | Memorial Hermann Medical Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1003985102 PECOS PAC ID: 7012008360 Enrollment ID: O20070801000368 |
| Entity Name | Ucp Physicians Of Central Texas, Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1922289412 PECOS PAC ID: 3173697935 Enrollment ID: O20080729000203 |
| Mailing Address | Practice Location Address |
|---|---|
| Mitalee Jiva, 1890 Research Forest Dr, Shenandoah, TX 77381-4566 Ph: (832) 658-3600 | Mitalee Jiva, 1890 Research Forest Dr, Shenandoah, TX 77381-4566 Ph: (832) 658-3600 |
Karen Lee Mackenney, RN, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 135 Vision Park Blvd, Shenandoah, TX 77384 Phone: 281-404-3000 Fax: 281-290-9824 | |
Mrs. Ronia J Khouri, AGACNP-BC, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 9250 Pinecroft Dr, Shenandoah, TX 77380 Phone: 713-897-2300 | |
Mr. Peter Robert Schultz, MSN, CRNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 17189 Interstate 45 S Ste 675, Shenandoah, TX 77385 Phone: 936-270-3905 Fax: 936-271-1584 | |
Miss Eliza Beth Codd, ARNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 150 Pine Forest Dr Ste 703, Shenandoah, TX 77384 Phone: 281-939-5915 Fax: 281-982-1808 | |
Summer Renee Shields, AGACNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 9250 Pinecroft Dr # N2.101, Shenandoah, TX 77380 Phone: 713-897-5539 Fax: 713-897-2275 | |
Maria Ivy Claborn, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 150 Pine Forest Dr Ste 101, Shenandoah, TX 77384 Phone: 832-610-2822 |