Provider Demographics
NPI:1720517014
Name:LIN, HAONAN (DPM)
Entity Type:Individual
Prefix:DR
First Name:HAONAN
Middle Name:
Last Name:LIN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2594
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77410-2594
Mailing Address - Country:US
Mailing Address - Phone:281-982-0868
Mailing Address - Fax:281-982-0866
Practice Address - Street 1:12238 QUEENSTON BLVD STE K
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77095-5351
Practice Address - Country:US
Practice Address - Phone:281-982-0868
Practice Address - Fax:281-982-0866
Is Sole Proprietor?:No
Enumeration Date:2017-06-08
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3031213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery