Provider Demographics
NPI:1164099347
Name:BABA, JEHAN MANSOUR (DC)
Entity Type:Individual
Prefix:DR
First Name:JEHAN
Middle Name:MANSOUR
Last Name:BABA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5915 BOGIE WAY
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77505-3040
Mailing Address - Country:US
Mailing Address - Phone:281-515-1026
Mailing Address - Fax:
Practice Address - Street 1:5915 BOGIE WAY
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77505-3040
Practice Address - Country:US
Practice Address - Phone:281-515-1026
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-07
Last Update Date:2021-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14662111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor