Healthcare Provider Details

I. General information

NPI: 1134934102
Provider Name (Legal Business Name): JIAMIN HUANG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2025
Last Update Date: 02/16/2025
Certification Date: 02/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2126 NALL ST
PORT NECHES TX
77651-3716
US

IV. Provider business mailing address

7218 SAUL ST
PHILADELPHIA PA
19149-1217
US

V. Phone/Fax

Practice location:
  • Phone: 409-727-1426
  • Fax:
Mailing address:
  • Phone: 215-609-9800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number75324
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: