Provider Demographics
NPI:1952520488
Name:VARMA, JAI (MD)
Entity Type:Individual
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First Name:JAI
Middle Name:
Last Name:VARMA
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Gender:M
Credentials:MD
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Mailing Address - Street 1:8150 N CENTRAL EXPY
Mailing Address - Street 2:STE M1001
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75206-1884
Mailing Address - Country:US
Mailing Address - Phone:318-675-7636
Mailing Address - Fax:318-675-5686
Practice Address - Street 1:1501 KINGS HWY
Practice Address - Street 2:CARDIOLOGY SECTION
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71103-4228
Practice Address - Country:US
Practice Address - Phone:318-675-5000
Practice Address - Fax:318-675-5686
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2023-03-08
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Provider Licenses
StateLicense IDTaxonomies
LA201395207RC0000X
TXP4124207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA4K583F600OtherMEDICARE - PTAN
LA1018856Medicaid