Individual
DR. VIKAS C. JAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1643 LANCASTER DR, SUITE 203, GRAPEVINE, TX 76051-3593
(817) 329-7670
(817) 416-0145
Mailing address
1643 LANCASTER DR, SUITE 203, GRAPEVINE, TX 76051-3593
(817) 329-7670
(817) 416-0145
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
L4468
TX
207UN0901X
Nuclear Cardiology Physician
L4468
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
153131104
—
TX
05
—
153131105
—
TX
01
—
8CM936
BCBSTX
TX
Enumeration date
08/12/2005
Last updated
06/28/2011
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