Provider Demographics
NPI:1578186847
Name:AIMSTX LLC
Entity Type:Organization
Organization Name:AIMSTX LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:KASHIF
Authorized Official - Middle Name:A
Authorized Official - Last Name:JANJUA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:574-208-9114
Mailing Address - Street 1:111 E 3RD ST
Mailing Address - Street 2:PO BOX 768
Mailing Address - City:MISHAWAKA
Mailing Address - State:IN
Mailing Address - Zip Code:46546
Mailing Address - Country:US
Mailing Address - Phone:219-309-9388
Mailing Address - Fax:574-747-8652
Practice Address - Street 1:16850 BUCCANEER LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-2507
Practice Address - Country:US
Practice Address - Phone:574-277-2630
Practice Address - Fax:574-747-8652
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AIMS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-05-21
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN01074952AOtherINDIANA LICENSE OF CEO