Provider Demographics
NPI:1235155144
Name:MADJITEY, GEORGE ERIC (MD)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:ERIC
Last Name:MADJITEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 CRAWFORD
Mailing Address - Street 2:111A
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77002
Mailing Address - Country:US
Mailing Address - Phone:713-651-9771
Mailing Address - Fax:713-650-8331
Practice Address - Street 1:2101 CRAWFORD
Practice Address - Street 2:111A
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77002
Practice Address - Country:US
Practice Address - Phone:713-651-9771
Practice Address - Fax:713-650-8331
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG2765207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
C18669Medicare UPIN
TXCV24Medicare ID - Type Unspecified