Provider Demographics
NPI:1013705144
Name:PENG, JASMINE MIAO (MD)
Entity type:Individual
Prefix:
First Name:JASMINE
Middle Name:MIAO
Last Name:PENG
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:MIAO
Other - Middle Name:
Other - Last Name:PENG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:301 WEST AVE UNIT 3706
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78701-4766
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6410 FANNIN ST STE 1400
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-5389
Practice Address - Country:US
Practice Address - Phone:832-325-7125
Practice Address - Fax:713-512-2200
Is Sole Proprietor?:No
Enumeration Date:2025-04-29
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program