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General NPI Number Information
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NPI Number | 1245608926
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Entity Type | Organization
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Legal Business Name | JAK VENTURES, PLLC
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Dates
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Enumeration Date | 09/11/2015
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Last Update Date | 09/11/2015
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Provider Practice Location Address
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Address Line | 915 GESSNER RD SUITE 640
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City | HOUSTON
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State | TX
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Zip | 77024-2538
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Country | US
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Telephone | 713-984-2222
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Fax | 713-467-6980
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Provider Business Mailing Address
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Address Line | 1406 COLUMBUS ST #201
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City | HOUSTON
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State | TX
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Zip | 77019-4760
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Country | US
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Telephone | 713-416-6581
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JULIA ANNE KAUFFMAN
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Credential | M.D.
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Telephone | 713-416-6581
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | P2134
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License Number State | TX
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