Provider Demographics
NPI:1225361223
Name:JIN, LI (DO)
Entity Type:Individual
Prefix:
First Name:LI
Middle Name:
Last Name:JIN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 HOLCOMBE BLVD UNIT 606
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-4214
Mailing Address - Country:US
Mailing Address - Phone:469-426-6878
Mailing Address - Fax:
Practice Address - Street 1:2001 HOLCOMBE BLVD UNIT 606
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-4214
Practice Address - Country:US
Practice Address - Phone:469-426-6878
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-09
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP100344002084P0800X
TXP56552084P0802X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry