Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 01068588A | IN |
N | 207Q00000X | Family Doctor | MD00046265 | WA |
Y | 207Q00000X | Family Doctor | P2270 | TX |
N | 207QS0010X | Family Doctor - Sports Medicine | 01068588A | IN |
NPI | 1043364839 |
---|---|
Provider Name | Vijay M. Jotwani |
First Address | Houston, TX 77027-5926 |
Second Address | Houston, TX 77027-5926 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/01/2007 |
Last Update Date | 08/01/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
331367801 | (05) | TX |
331367802 | (05) | TX |
8DH104 | BLUE CROSS BLUE SHIELD (01) | TX |
8DY923 | BLUE CROSS BLUE SHIELD (01) | TX |
P01110846 | RR MEDICARE (01) | TX |
P01510480 | RR MEDICARE (01) | TX |