Provider Demographics
NPI:1215196092
Name:CHIN, PAUL CARL (MD, PHD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:CARL
Last Name:CHIN
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6767 LAKE WOODLANDS DR STE F
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77382-2566
Mailing Address - Country:US
Mailing Address - Phone:281-364-1122
Mailing Address - Fax:281-210-2446
Practice Address - Street 1:6767 LAKE WOODLANDS DR STE F
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77382-2566
Practice Address - Country:US
Practice Address - Phone:281-364-1122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-05
Last Update Date:2019-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXN8173207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program