Provider Demographics
NPI:1083641880
Name:JON, CINDY KAM-TAI (MD)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:KAM-TAI
Last Name:JON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6431 FANNIN
Mailing Address - Street 2:MSB 3.228
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030
Mailing Address - Country:US
Mailing Address - Phone:713-500-5650
Mailing Address - Fax:713-500-0588
Practice Address - Street 1:6431 FANNIN
Practice Address - Street 2:MSB 3.228
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030
Practice Address - Country:US
Practice Address - Phone:713-500-5650
Practice Address - Fax:713-500-0588
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL7766208000000X, 2080P0214X, 2080S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080S0012XAllopathic & Osteopathic PhysiciansPediatricsSleep Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric Pulmonology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXI36389Medicare UPIN
TX8D7117Medicare PIN
TX8L20349Medicare PIN
TX174550706Medicaid