Provider Demographics
NPI:1134898869
Name:NAIK, JAGAVI (OD)
Entity type:Individual
Prefix:
First Name:JAGAVI
Middle Name:
Last Name:NAIK
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5610 GRAND PKWY
Mailing Address - Street 2:#500
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77406
Mailing Address - Country:US
Mailing Address - Phone:281-232-2024
Mailing Address - Fax:281-232-2013
Practice Address - Street 1:5610 GRAND PKWY
Practice Address - Street 2:#500
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77406
Practice Address - Country:US
Practice Address - Phone:281-232-2024
Practice Address - Fax:281-232-2013
Is Sole Proprietor?:No
Enumeration Date:2021-09-07
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10259TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist