Provider Demographics
NPI:1184742041
Name:AVANINDRA JAIN, M.D.P.A.
Entity type:Organization
Organization Name:AVANINDRA JAIN, M.D.P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CARDIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:AVANINDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:JAIN
Authorized Official - Suffix:
Authorized Official - Credentials:MDPA
Authorized Official - Phone:210-637-0091
Mailing Address - Street 1:2455 NE LOOP 410
Mailing Address - Street 2:SUITE 235
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78217-5649
Mailing Address - Country:US
Mailing Address - Phone:210-637-0091
Mailing Address - Fax:210-637-0094
Practice Address - Street 1:2455 NE LOOP 410
Practice Address - Street 2:SUITE 235
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-5649
Practice Address - Country:US
Practice Address - Phone:210-637-0091
Practice Address - Fax:210-637-0094
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ0539174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty