Provider Demographics
NPI:1073811832
Name:HAN, SHAOJIE (MD)
Entity Type:Individual
Prefix:DR
First Name:SHAOJIE
Middle Name:
Last Name:HAN
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 1:4888 LOOP CENTRAL DR
Mailing Address - Street 2:STE 510
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77081-2226
Mailing Address - Country:US
Mailing Address - Phone:917-573-2283
Mailing Address - Fax:
Practice Address - Street 1:4888 LOOP CENTRAL DR
Practice Address - Street 2:STE 510
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77081-2226
Practice Address - Country:US
Practice Address - Phone:713-346-1551
Practice Address - Fax:713-346-1557
Is Sole Proprietor?:No
Enumeration Date:2011-03-03
Last Update Date:2021-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY60 2798622084P0800X
TXQ80712084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX358546501Medicaid