Provider Demographics
NPI:1104840768
Name:LIN, JIMMY C (DC)
Entity Type:Individual
Prefix:
First Name:JIMMY
Middle Name:C
Last Name:LIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2811 OAKLAND DR
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-3026
Mailing Address - Country:US
Mailing Address - Phone:281-389-6800
Mailing Address - Fax:
Practice Address - Street 1:9889 BELLAIRE BLVD
Practice Address - Street 2:#134
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-3463
Practice Address - Country:US
Practice Address - Phone:281-389-6800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10352111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor