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Individual
DR. JYOTI JAIN
Active
Individual
DR. JYOTI JAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
J9110
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00T52V
BLUE SHIELD
TX
05
—
111658401
—
TX
01
—
75-2795302
TAX ID
TX
Enumeration date
08/12/2006
Last updated
04/18/2012
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