Provider Demographics
NPI:1497908883
Name:JADAV, DIP SURESHKUMAR (MD)
Entity Type:Individual
Prefix:
First Name:DIP
Middle Name:SURESHKUMAR
Last Name:JADAV
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 16789
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77496-6789
Mailing Address - Country:US
Mailing Address - Phone:281-242-1242
Mailing Address - Fax:281-886-8687
Practice Address - Street 1:3507 TOWN CENTER BLVD S
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-2654
Practice Address - Country:US
Practice Address - Phone:281-242-1242
Practice Address - Fax:281-886-8687
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-29
Last Update Date:2022-07-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXP6649207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology