Provider Demographics
NPI:1346354065
Name:JIN, JIMMY X (OMD)
Entity Type:Individual
Prefix:MR
First Name:JIMMY
Middle Name:X
Last Name:JIN
Suffix:
Gender:M
Credentials:OMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12335 SHADOW GREEN DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-5642
Mailing Address - Country:US
Mailing Address - Phone:281-870-8818
Mailing Address - Fax:
Practice Address - Street 1:8989 WESTHEIMER RD
Practice Address - Street 2:STE. 301
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-3621
Practice Address - Country:US
Practice Address - Phone:713-988-8849
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2008-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC00098171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist