Organization Active NPI

Jak Ventures, PLLC

  • Dermatology Physician
  • Houston, TX
National Provider Identifier
1245608926
Registry record updated Sep 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
P2134 Issued in TX
Legal business name
JAK VENTURES, PLLC
Practice address
915 Gessner Rd
Suite 640
Houston, TX 77024-2538
Phone
(713) 984-2222
Fax
(713) 467-6980
NPI assigned
Sep 11, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Julia Anne Kauffman, M.D.NPI 1467710806
Title
President
Phone
(713) 416-6581

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X P2134 TX Primary

Addresses

Primary practice location

915 Gessner Rd
Suite 640
Houston, TX 77024-2538

Mailing address

1406 Columbus St
#201
Houston, TX 77019-4760
Phone (713) 416-6581

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150925002533 TX Part B Supplier - Clinic/Group Practice 6305154238 Receives reassigned benefits from 1 practitioner
Practice locations: Houston, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1441929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441929600000",
    "number": "1245608926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1406 COLUMBUS ST",
            "address_2": "#201",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770194760",
            "telephone_number": "713-416-6581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 GESSNER RD",
            "address_2": "SUITE 640",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770242538",
            "telephone_number": "713-984-2222",
            "fax_number": "713-467-6980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAK VENTURES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-11",
        "last_updated": "2015-09-11",
        "status": "A",
        "authorized_official_last_name": "KAUFFMAN",
        "authorized_official_first_name": "JULIA",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "713-416-6581",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "TX",
            "license": "P2134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.