Provider Demographics
NPI:1558660886
Name:JAIN, MAHIM (MD PHD)
Entity Type:Individual
Prefix:DR
First Name:MAHIM
Middle Name:
Last Name:JAIN
Suffix:
Gender:M
Credentials:MD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6621 FANNIN ST STE A170
Mailing Address - Street 2:TEXAS CHILDRENS HOSPITAL
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2303
Mailing Address - Country:US
Mailing Address - Phone:832-824-1192
Mailing Address - Fax:832-825-1187
Practice Address - Street 1:6621 FANNIN ST STE A170
Practice Address - Street 2:TEXAS CHILDRENS HOSPITAL
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2303
Practice Address - Country:US
Practice Address - Phone:832-824-1192
Practice Address - Fax:832-825-1187
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-25
Last Update Date:2011-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10036911-549768208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics