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NPI Code Detail

MEDICARE: PRACHI JAIN ITALIYA DO

MEDICARE:   PRACHI JAIN ITALIYA  DO
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
1207Q00000XFamily Medicine PhysicianR6418TX
2207QG0300XGeriatric Medicine (Family Medicine) PhysicianR6418TX

General Provider Information

NPI Number : 1891159372
Entity Type Code : Individual
Provider Name (Legal Business Name) : PRACHI JAIN ITALIYA DO
Provider Business Mailing Address
First Line : 5846 WOOLDRIDGE RD
Second Line :
City : CORPUS CHRISTI
State : TX
Zip : 78414-2402
Country : US
Telephone Number : 361-994-8979
Fax Number : 361-994-8966
Provider Business Practice Location Address
First Line : 5846 WOOLDRIDGE RD
Second Line :
City : CORPUS CHRISTI
State : TX
Zip : 78414-2402
Country : US
Telephone Number : 361-994-8979
Fax Number : 361-994-8966
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2016
Last Update Date : 09/23/2021

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Directions to “ PRACHI JAIN ITALIYA DO” Practice Location

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