Provider Demographics
NPI:1336128909
Name:JAIN, TULIKA (MD)
Entity Type:Individual
Prefix:
First Name:TULIKA
Middle Name:
Last Name:JAIN
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 1:1005 W RALPH HALL PKWY STE 137
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75032-6691
Mailing Address - Country:US
Mailing Address - Phone:214-369-3613
Mailing Address - Fax:972-932-3700
Practice Address - Street 1:1005 W RALPH HALL PKWY STE 137
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75032
Practice Address - Country:US
Practice Address - Phone:214-369-3613
Practice Address - Fax:972-932-3700
Is Sole Proprietor?:No
Enumeration Date:2006-01-12
Last Update Date:2018-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL0299207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX207536OtherABIM CANDIDATE NUMBER
8V3678OtherBCBS
TXP00351093OtherRAILROAD
TX207536OtherABIM CANDIDATE NUMBER
TXP00351093OtherRAILROAD
TX8G8381Medicare PIN