Provider Demographics
NPI:1134308877
Name:FAN, JINPING (MD)
Entity Type:Individual
Prefix:DR
First Name:JINPING
Middle Name:
Last Name:FAN
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 1:2217 NAOMI ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-3823
Mailing Address - Country:US
Mailing Address - Phone:281-866-0073
Mailing Address - Fax:281-866-0074
Practice Address - Street 1:17115 RED OAK DR
Practice Address - Street 2:STE 218
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-2641
Practice Address - Country:US
Practice Address - Phone:281-866-0073
Practice Address - Fax:281-866-0074
Is Sole Proprietor?:No
Enumeration Date:2007-10-30
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM1664207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine