Healthcare Provider Details

I. General information

NPI: 1326092941
Provider Name (Legal Business Name): AJAYKUMAR JANI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 W 5TH ST
ODESSA TX
79763-4206
US

IV. Provider business mailing address

10501 TROY AVE
LUBBOCK TX
79424-7899
US

V. Phone/Fax

Practice location:
  • Phone: 432-335-2222
  • Fax: 432-335-5354
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberT2637
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: