MEDICARE: DR. JEANIE CHOI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician	M8600	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	197227502	OTHER	TX	CSHCN
2	8AL159	OTHER	TX	BLUE CROSS BLUE SHIELD
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1962673194
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEANIE CHOI M.D.

Provider Business Mailing Address
First Line	:	4108 LILLIAN ST
Second Line	:	UNIT B
City	:	HOUSTON
State	:	TX
Zip	:	77007-5645
Country	:	US
Telephone Number	:	713-864-2229
Fax Number	:

Provider Business Practice Location Address
First Line	:	4108 LILLIAN ST
Second Line	:	UNIT B
City	:	HOUSTON
State	:	TX
Zip	:	77007-5645
Country	:	US
Telephone Number	:	832-721-3833
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/15/2008
Last Update Date	:	04/07/2009

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