Provider Demographics
NPI:1629349147
Name:QIAN, JIN (OD)
Entity Type:Individual
Prefix:
First Name:JIN
Middle Name:
Last Name:QIAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 TERRI PARK WAY
Mailing Address - Street 2:SUITE 302
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-5099
Mailing Address - Country:US
Mailing Address - Phone:713-366-6270
Mailing Address - Fax:
Practice Address - Street 1:211 TERRI PARK WAY
Practice Address - Street 2:SUITE 302
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-5099
Practice Address - Country:US
Practice Address - Phone:713-366-6270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-13
Last Update Date:2016-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNOD0000003353152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist