Provider Demographics
NPI:1225017403
Name:SINDHAV, JIVANTIKA (MD)
Entity Type:Individual
Prefix:
First Name:JIVANTIKA
Middle Name:
Last Name:SINDHAV
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12221 N MOPAC EXPY
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-2401
Mailing Address - Country:US
Mailing Address - Phone:512-901-4038
Mailing Address - Fax:512-901-3908
Practice Address - Street 1:2400 CEDAR BEND DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-5378
Practice Address - Country:US
Practice Address - Phone:512-901-4026
Practice Address - Fax:512-901-3940
Is Sole Proprietor?:No
Enumeration Date:2006-01-16
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE24443207Q00000X
IAIA35442207Q00000X
TXR9542207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47068731741Medicaid
NE47068731749Medicaid
NE47068731734Medicaid
NE10026480100Medicaid
NE47068731721Medicaid
IA1225017403Medicaid
NE47068731749Medicaid