Provider Demographics
NPI:1215794284
Name:JAGGU HEALTHCARE & INNOVATIONS PLLC
Entity type:Organization
Organization Name:JAGGU HEALTHCARE & INNOVATIONS PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:VIJAYENDRA
Authorized Official - Middle Name:RAO
Authorized Official - Last Name:JALIGAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:504-289-3788
Mailing Address - Street 1:1945 OLD GALLOWS RD STE 535
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-3983
Mailing Address - Country:US
Mailing Address - Phone:571-470-6243
Mailing Address - Fax:571-200-2617
Practice Address - Street 1:1945 OLD GALLOWS RD STE 535
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-3983
Practice Address - Country:US
Practice Address - Phone:571-470-6243
Practice Address - Fax:571-200-2617
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-05
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center