Provider Demographics
NPI:1083022578
Name:JIN, JIAHE (MD(CHINA) LIC ACP)
Entity Type:Individual
Prefix:DR
First Name:JIAHE
Middle Name:
Last Name:JIN
Suffix:
Gender:F
Credentials:MD(CHINA) LIC ACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10209 ANDORA DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78717-4563
Mailing Address - Country:US
Mailing Address - Phone:716-622-5698
Mailing Address - Fax:
Practice Address - Street 1:1707 FORTVIEW RD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-7620
Practice Address - Country:US
Practice Address - Phone:512-445-2222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-28
Last Update Date:2014-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC01501171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist