Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 2008-00424 | NC |
Y | 2080P0216X | Pediatric Rheumatologist | 2008-00424 | NC |
NPI | 1962670232 |
---|---|
Provider Name | Ivan Chinn |
First Address | Houston, TX 77046-0207 |
Second Address | Houston, TX 77030-2608 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/02/2008 |
Last Update Date | 18/06/2014 |