Provider Demographics
NPI:1407883259
Name:JIANG, NAN (MD)
Entity Type:Individual
Prefix:
First Name:NAN
Middle Name:
Last Name:JIANG
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 1:9999 BELLAIRE BLVD
Mailing Address - Street 2:STE 370
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-3579
Mailing Address - Country:US
Mailing Address - Phone:713-270-0909
Mailing Address - Fax:713-270-1226
Practice Address - Street 1:9750 BELLAIRE BLVD
Practice Address - Street 2:STE 180
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-3445
Practice Address - Country:US
Practice Address - Phone:713-270-0909
Practice Address - Fax:713-270-1226
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2016-12-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXL6965207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8B5818Medicare ID - Type Unspecified
TXH76106Medicare UPIN