Provider Demographics
NPI:1871888438
Name:JARIWALA, UJJVAL BANKIMCHANDRA (MD)
Entity type:Individual
Prefix:DR
First Name:UJJVAL
Middle Name:BANKIMCHANDRA
Last Name:JARIWALA
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 1:1200 BINZ ST STE 1200
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77004-6926
Mailing Address - Country:US
Mailing Address - Phone:832-973-8167
Mailing Address - Fax:713-795-4651
Practice Address - Street 1:1200 BINZ ST STE 1200
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77004-6926
Practice Address - Country:US
Practice Address - Phone:832-973-8167
Practice Address - Fax:713-795-4651
Is Sole Proprietor?:No
Enumeration Date:2011-06-12
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2017-0115207R00000X
TXQ4144207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX360302901Medicaid
TX360302902Medicaid
TX360302903Medicaid
TX360302902Medicaid
TX360302901Medicaid
TX360302903Medicaid