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Contact Information

PETER S JEROME, MD
700 E MARSHALL AVE
LONGVIEW, TX75601-5580
 Phone: 903-315-1488
 Fax: 903-315-1656
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pulmonary Disease

207RP1001X 11 Physician/Internal Medicine
 

Critical Care Medicine

207RC0200X 11 Physician/Internal Medicine
 

Sleep Medicine

207RS0012X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for PETER S JEROME · (Male)

NPI # 1396740668
Status Active
Credentials MD
Entity Individual
Enumeration date 06/14/2005
Last updated 01/11/2021 - About 5 years ago
Sole proprietor 1 No
Identifiers
  • ID License # M-12784
  • MN License # 51376
  • ND License # 12731
  • TX License # P4321
  • WI License # 23793
  • IA Medicaid ENROLLED
  • TX Medicaid 393948001
  • WI Medicaid 31692500
  • MN Other P00849680 RAILROAD MEDICARE
  • TX Other P02137176 MEDICARE RAILROAD
Hospital affiliation(s)
  • MEMORIAL HERMANN HOSPITAL SYSTEM - (Acute Care)
    1635 NORTH LOOP WEST
    HOUSTON, TX 77008
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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