Individual
DR. JAYA VANISTI JUTURI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
8220 WALNUT HILL LN, SUITE 700, DALLAS, TX 75231-4427
(214) 739-4175
(214) 987-4161
Mailing address
PO BOX 911230, DALLAS, TX 75391-1230
(972) 997-8000
(972) 234-0813
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
L2957
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
148695301
—
TX
05
—
148695302
—
TX
05
—
148695303
—
TX
01
—
8CA989
BLUECROSS BLUESHIELD OF TEXAS
TX
01
—
P00789794
RAILROAD MEDICARE
TX
Enumeration date
10/14/2005
Last updated
03/11/2010
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