Jyoti Jain, M.D.

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

J9110 Issued in TX

Practice address

6448 Broadway Blvd
Garland, TX 75043-5943

Phone

(972) 216-8500

Fax

(972) 216-8521

NPI assigned

Aug 12, 2006

Last updated

Apr 18, 2012By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Jyoti Jain, MD, PA

  • Pediatrics Physician
  • Garland, TX
  • NPI 1336417039
  Authorized official Same address or phone

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334707200000",
    "number": "1932111945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1209 CREEKWOOD DR",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750442421",
            "telephone_number": "972-216-8500",
            "fax_number": "972-216-8521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6448 BROADWAY BLVD",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750435943",
            "telephone_number": "972-216-8500",
            "fax_number": "972-216-8521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAIN",
        "first_name": "JYOTI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-12",
        "last_updated": "2012-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "TX",
            "license": "J9110",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00T52V",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111658401",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "75-2795302",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Breiana Jacobs, LCSW
• Jade Quality Care, Inc
• Kamran Adil Jafree
• Jaicstar Home Care Inc (Dependable Home Care of Texoma)
• Jaime Villarreal D.D.S. PLLC
• Olufunke Jaiyeola, PHARM. D
• Theresa Zainab Jalloh
• Shanae Jamerson
• James B Maddox MD PA
• James W. Moore, DDS, MSD, Inc

• Pediatric Adolescent Medicine Physician in Garland, TX
• Providers in Garland, TX by specialty
• Pediatric Adolescent Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.