Provider Demographics
NPI:1730375551
Name:JMAX CLINIC, PA
Entity type:Organization
Organization Name:JMAX CLINIC, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:832-766-3990
Mailing Address - Street 1:3115 TIMBERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-3818
Mailing Address - Country:US
Mailing Address - Phone:832-766-3990
Mailing Address - Fax:713-436-6974
Practice Address - Street 1:10970 SHADOW CREEK PKWY STE 250
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-0121
Practice Address - Country:US
Practice Address - Phone:713-436-9475
Practice Address - Fax:713-436-9059
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-16
Last Update Date:2007-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM5568261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXI71585Medicare UPIN