Healthcare Provider Details

I. General information

NPI: 1336992460
Provider Name (Legal Business Name): JING HAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2024
Last Update Date: 10/31/2025
Certification Date: 10/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 BONAVENTURE WAY STE 119
SUGAR LAND TX
77479-8005
US

IV. Provider business mailing address

10514 KINGSTON SPRING DR
MISSOURI CITY TX
77459-5486
US

V. Phone/Fax

Practice location:
  • Phone: 832-730-7246
  • Fax: 844-302-5696
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number1042162
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: