Provider Demographics
NPI:1144669508
Name:MD ANDERSON
Entity type:Organization
Organization Name:MD ANDERSON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM MANAGER, PATHOLOGY FELLOW
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREEN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-792-3108
Mailing Address - Street 1:1123 ANDOVER DR
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-2271
Mailing Address - Country:US
Mailing Address - Phone:321-278-0131
Mailing Address - Fax:
Practice Address - Street 1:1515 HOLCOMBE BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-4000
Practice Address - Country:US
Practice Address - Phone:713-792-2121
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-19
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP5415284300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes284300000XHospitalsSpecial Hospital