Healthcare Provider Details

I. General information

NPI: 1700049285
Provider Name (Legal Business Name): TAPAN JANI D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2008
Last Update Date: 01/07/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 W MAYFIELD RD STE 201
ARLINGTON TX
76014-2083
US

IV. Provider business mailing address

16980 DALLAS PARKWASY STE 200
DALLAS TX
75248
US

V. Phone/Fax

Practice location:
  • Phone: 817-784-1238
  • Fax: 817-467-3083
Mailing address:
  • Phone: 972-391-1915
  • Fax: 972-391-2061

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number125055420
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberQ4992
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: