Provider Demographics
NPI:1225031321
Name:MERIN, JAN M (MD)
Entity Type:Individual
Prefix:
First Name:JAN
Middle Name:M
Last Name:MERIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1330 WIRT RD STE R
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77055-4901
Mailing Address - Country:US
Mailing Address - Phone:346-406-1730
Mailing Address - Fax:
Practice Address - Street 1:1330 WIRT RD STE R
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055-4901
Practice Address - Country:US
Practice Address - Phone:346-406-1730
Practice Address - Fax:346-388-1414
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2023-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM92-304207RX0202X
TXS9035207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM14065Medicaid
NM900521294OtherMEDICARE GROUP
349433501Medicare ID - Type Unspecified
NM14065Medicaid