Provider Demographics
NPI:1922480839
Name:HUYNH, JEANNIE LOAN (MD)
Entity Type:Individual
Prefix:
First Name:JEANNIE
Middle Name:LOAN
Last Name:HUYNH
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 1:2304 BRISTOL WATER DR
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-7869
Mailing Address - Country:US
Mailing Address - Phone:832-344-6761
Mailing Address - Fax:
Practice Address - Street 1:2017 BROADWAY ST UNIT A
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77581-5501
Practice Address - Country:US
Practice Address - Phone:281-485-9990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-26
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR7767208000000X
TXBP10053996208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics