Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | M4200 | TX |
N | 111NI0900X | Internist | M4200 | TX |
N | 207RC0200X | Critical Care Medicine | M4200 | TX |
Y | 207RP1001X | Pulmonary Disease | M4200 | TX |
NPI | 1063426674 |
---|---|
Provider Name | Dr. Ajay Jain |
First Address | Houston, TX 77024-2402 |
Second Address | Houston, TX 77024-2420 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2006 |
Last Update Date | 27/05/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
192766701 | (05) | TX |
M4200 | (02) | TX |