MEDICARE: AYESHA JAIN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician	BP10050280	TX
2	207LP2900X	Pain Medicine (Anesthesiology) Physician	S5190	TX
3	207L00000X	Anesthesiology Physician	S5190	TX

General Provider Information

NPI Number	:	1033529672
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AYESHA JAIN MD

Provider Business Mailing Address
First Line	:	1740 W TAYLOR ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60612-7232
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	707 S FRY RD STE 290
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77450-2258
Country	:	US
Telephone Number	:	281-946-2660
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/05/2014
Last Update Date	:	05/06/2026

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Directions to “ AYESHA JAIN MD” Practice Location

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