Provider Demographics
NPI:1295816734
Name:HAN, JEANNIE YOUJIN (DO)
Entity Type:Individual
Prefix:
First Name:JEANNIE
Middle Name:YOUJIN
Last Name:HAN
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 1:250 BLOSSOM ST
Mailing Address - Street 2:350
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-4204
Mailing Address - Country:US
Mailing Address - Phone:832-553-5430
Mailing Address - Fax:281-554-6705
Practice Address - Street 1:250 BLOSSOM ST
Practice Address - Street 2:350
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4204
Practice Address - Country:US
Practice Address - Phone:832-553-5430
Practice Address - Fax:281-554-6705
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2009-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM4807207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology