Provider Demographics
NPI:1871519744
Name:JOYKUTTY, JESSY (DO)
Entity type:Individual
Prefix:
First Name:JESSY
Middle Name:
Last Name:JOYKUTTY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9101 N CENTRAL EXPY
Mailing Address - Street 2:SUITE 250
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-5927
Mailing Address - Country:US
Mailing Address - Phone:214-286-2979
Mailing Address - Fax:214-828-9169
Practice Address - Street 1:9101 N CENTRAL EXPY
Practice Address - Street 2:SUITE 250
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-5927
Practice Address - Country:US
Practice Address - Phone:214-286-2979
Practice Address - Fax:214-828-9169
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2013-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL6446207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX165133303Medicaid
TX8P1262OtherBCBS
TX165133303Medicaid
TX8P1262OtherBCBS
TX8G6769Medicare ID - Type Unspecified