DR. MARIA AUDRIE DE JESUS MD NPI 1336176387

NPI Information

NPI: 1336176387
Provider Name: DR. MARIA AUDRIE DE JESUS, MD
Classification: Psychiatry & Neurology - 2084N0400X
Entity Type: Individual

Specialization: Neurology

PECOS Registration: Yes

Address:
500 THROCKMORTON STREET
UNIT 3309
FORT WORTH, TX
ZIP 76102
Phone: (817) 908-8124
Get Directions

DR. Maria Audrie De Jesus, MD is a neurology psychiatry neurology in Fort Worth, TX with 38 years of experience. The provider is a Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. DR. Maria Audrie De Jesus, MD NPI is 1336176387. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

500 THROCKMORTON STREET
UNIT 3309
FORT WORTH, TX
ZIP 76102
Phone: (817) 908-8124
Fax: (817) 885-7339

The NPI 1336176387 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/26/2006 and was last updated on 6/3/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	204D00000X	Neuromusculoskeletal Medicine & OMM		P4641	TEXAS	No
2	2084N0400X	Psychiatry & Neurology	Neurology	P4641	TEXAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	2399196	OTHER	NEW YORK	UNITED HEALTHCARE
2	DM6602	OTHER	NEW YORK	ATLANTIS BEHAVIORAL HEALT
3	4C9461	OTHER	NEW YORK	HEALTH NET
4	30440476	OTHER	NEW YORK	MAGNACARE
5	53N521	OTHER	NEW YORK	EMPIRE BCBS
6	7745380	OTHER	NEW YORK	CIGNA HEALTHCARE
7	902408901	OTHER	NEW YORK	AMERICHOICE
8	3099038	OTHER	NORTH CAROLINA	GHI HEALTH PLANS
9	P3241805	OTHER	NEW YORK	OXFORD
10	206602	OTHER	NEW YORK	HIP HEALTH PLAN OF NY
11	3283244 07	MEDICAID	TEXAS
12	01872586	MEDICAID	NEW YORK
13	030440476DE02	OTHER	NEW YORK	CARE PLUS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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