Basic Information
Provider Information
NPI: 1336628734
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: THAKKAR
FirstName: JAHNVI
MiddleName: HARESHKUMAR
NamePrefix:  
NameSuffix:  
Credential: DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1200 CORPORATE DR STE 400
Address2:  
City: HOOVER
State: AL
PostalCode: 352425424
CountryCode: US
TelephoneNumber: 4235415492
FaxNumber:  
Practice Location
Address1: 8475 HIGHWAY 6 N STE K
Address2:  
City: HOUSTON
State: TX
PostalCode: 770952049
CountryCode: US
TelephoneNumber: 2815072619
FaxNumber: 2814073606
Other Information
ProviderEnumerationDate: 08/07/2018
LastUpdateDate: 05/16/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/16/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X1283780TXY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 
225100000X TXN Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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