Basic Information
| Provider Information | |||||||||
| NPI: | 1336343847 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ESTEP | ||||||||
| FirstName: | JERRY | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6550 FANNIN ST | ||||||||
| Address2: | SUITE 1901 | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770302717 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7134411100 | ||||||||
| FaxNumber: | 7137902643 | ||||||||
| Practice Location | |||||||||
| Address1: | 6550 FANNIN ST | ||||||||
| Address2: | SUITE 1901 | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770302717 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7134411100 | ||||||||
| FaxNumber: | 7137902643 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/11/2007 | ||||||||
| LastUpdateDate: | 11/30/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | L3960 | TX | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RC0000X | L3960 | TX | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | 207RI0011X | L3960 | TX | N | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology |
ID Information
| ID | Type | State | Issuer | Description | P00433682 | 01 | TX | RAILROAD MEDICARE | OTHER | 8W8477 | 01 | TX | BLUE CROSS BLUE SHIELD | OTHER | P01036884 | 01 | TX | RR MEDICARE | OTHER | P01309338 | 01 | TX | RR MEDICARE | OTHER | 153524703 | 05 | TX | MEDICAID | 153524704 | 05 | TX | MEDICAID | 153524702 | 05 | TX | MEDICAID | 1886548 | 05 | LA | MEDICAID | 8W8477 | 01 | TX | BCBS | OTHER |