Provider Demographics
NPI:1164531273
Name:HSIANG, JIM (MD)
Entity Type:Individual
Prefix:MR
First Name:JIM
Middle Name:
Last Name:HSIANG
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 1:601 TAXAN TRAIL SUITE 100
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-2548
Mailing Address - Country:US
Mailing Address - Phone:361-884-6381
Mailing Address - Fax:361-882-7716
Practice Address - Street 1:1205 S 19TH ST
Practice Address - Street 2:SUITE A
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78405-1527
Practice Address - Country:US
Practice Address - Phone:361-561-4193
Practice Address - Fax:361-881-8149
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2013-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA73170174400000X
TXL92522085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXH85327Medicare UPIN
TX1164531273Medicare PIN
CAH85327Medicare UPIN
CA00A731700Medicare ID - Type Unspecified