Provider Demographics
NPI:1962596577
Name:GOEL, JAI NARAIN (DOMS)
Entity type:Individual
Prefix:
First Name:JAI
Middle Name:NARAIN
Last Name:GOEL
Suffix:
Gender:M
Credentials:DOMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2005 WEST UNIVERSITY DRIVE
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78541
Mailing Address - Country:US
Mailing Address - Phone:956-318-1400
Mailing Address - Fax:956-318-0022
Practice Address - Street 1:2005 W UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-2831
Practice Address - Country:US
Practice Address - Phone:956-399-8463
Practice Address - Fax:956-399-8264
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2010-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF4841207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0031PTOtherBLUECROSSBLUESHIELD
TX029806901Medicaid
TXH26111Medicare UPIN
TX00212MMedicare PIN
TX00212MMedicare ID - Type UnspecifiedMEDCARE