Provider Demographics
NPI:1952469314
Name:JADAV, PARESH (MD)
Entity Type:Individual
Prefix:DR
First Name:PARESH
Middle Name:
Last Name:JADAV
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6411 FANNIN ST STE J1.400
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-1501
Mailing Address - Country:US
Mailing Address - Phone:713-500-7437
Mailing Address - Fax:713-500-0785
Practice Address - Street 1:6411 FANNIN ST STE J1400
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-1501
Practice Address - Country:US
Practice Address - Phone:713-704-4071
Practice Address - Fax:713-500-0785
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY310160207R00000X, 207RN0300X
WAMD00040832207RN0300X
TXL9259207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX174903801Medicaid
WA2061905Medicaid
TXI20821Medicare UPIN
WA2061905Medicaid
TX174903801Medicaid