JIE PAN (NPI# 1609369990) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609369990 |
| Entity Type | Individual |
| Full Name | JIE PAN |
| Credential | MD |
| Practice Address |
3601 4th St Stop 8321 Lubbock TX 79430-8321 |
| Practice Telephone | 8067433832 |
| Enumeration Date | 2018-06-11 |
| Last Update Date | 2018-06-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
BP10063318 | TX | Allopathic & Osteopathic Physicians |
| Street Address |
3601 4TH ST STOP 8321 |
| City | LUBBOCK |
| State | TX |
| Zip Code | 79430-8321 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619383056 | Doungporn Ruthirago | Psychiatry & Neurology | 3601 4th St Stop 8321, Department of Neurology, Lubbock, TX 79430-8321 | 2014-07-07 |
| 1205442399 | Werdah Hunain | Student in an Organized Health Care Education/Training Program | 3601 4th St Stop 8321, Lubbock, TX 79430-0002 | 2020-09-23 |
| 1548883283 | Yuanyuan Tan | Student in an Organized Health Care Education/Training Program | 3601 4th St Stop 8321, Lubbock, TX 79430-0002 | 2020-05-27 |
| 1780207621 | Roberto Manuel Hernandez Quintana | Student in an Organized Health Care Education/Training Program | 3601 4th St Stop 8321, Lubbock, TX 79430-8321 | 2020-05-27 |
| 1215599410 | Tulio Arnaldo Bueso | Student in an Organized Health Care Education/Training Program | 3601 4th St Stop 8321, Lubbock, TX 79430-8321 | 2019-07-08 |
| 1629635503 | Victor Carlos Montalvan | Student in an Organized Health Care Education/Training Program | 3601 4th St Stop 8321, Lubbock, TX 79430-8321 | 2019-05-25 |
| 1063079051 | Jeannie Jisun Lee | Student in an Organized Health Care Education/Training Program | 3601 4th St Stop 8321, Lubbock, TX 79430-0002 | 2019-05-24 |
| 1528547593 | Igor Queiroz Campos Arauj | Student in an Organized Health Care Education/Training Program | 3601 4th St Stop 8321, Lubbock, TX 79430-8321 | 2018-08-10 |
| 1053805432 | Amputch Karukote | Student in an Organized Health Care Education/Training Program | 3601 4th St Stop 8321, Lubbock, TX 79430-8321 | 2018-06-19 |
| 1851815146 | Walter Rodrigo Duarte Celada | Student in an Organized Health Care Education/Training Program | 3601 4th St Stop 8321, Lubbock, TX 79430-8321 | 2017-07-28 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730702473 | Emily Bouffard | Student in an Organized Health Care Education/Training Program | 3601 4th Street Mail Stop 8143, Lubbock, TX 79430 | 2020-05-27 |
| 1891350310 | Erin Leigh Burton | Student in an Organized Health Care Education/Training Program | 3601 Fourth Street, Department of Surgery Ms 8312, Lubbock, TX 79430 | 2019-05-09 |
| 1851861439 | Zachery Brian Sneed | Counselor | 3b310, 3601 4th St Stop 6225, Lubbock, TX 79430 | 2018-11-27 |
| 1831683481 | Swagat Parajulee | Student in an Organized Health Care Education/Training Program | 3601 4th St., Stop 9410, Office 4b076, Lubbock, TX 79430 | 2018-06-18 |
| 1649711904 | William David Boothe Jr. | Dermatology | 3601 4th St Stop 6211, Lubbock, TX 79430 | 2017-03-19 |
| 1982144945 | Kazutaka Araki | Specialist/Technologist | 3601, 4th St, Lubbock, TX 79430 | 2017-02-24 |
| 1659725125 | Thomas Gregory Wyatt | Student in an Organized Health Care Education/Training Program | 3601 4th St Rm 3a122b, Lubbock, TX 79430 | 2016-04-20 |
| 1619391760 | Chinyere Mbagwu | General Practice | 3601 4th St # Ms 8143, Lubbock, TX 79430 | 2014-02-10 |
| 1982044111 | Eileen Mary Sprys | Family Medicine | 3601 4th St., Stop 8143, Lubbock, TX 79430 | 2013-07-02 |
| 1205196243 | Hilmi Alam | Family Medicine | Department of Family & Community Medicine, 3601 4th Street, Stop 8143, Lubbock, TX 79430 | 2012-05-24 |
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| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619383056 | Doungporn Ruthirago | Psychiatry & Neurology | 3601 4th St Stop 8321, Department of Neurology, Lubbock, TX 79430-8321 | 2014-07-07 |
| 1528259900 | Benjamin J. Williams Md, Phd, Pa | Psychiatry & Neurology | 4642 N Loop 289 Ste 203, Lubbock, TX 79416-2424 | 2007-08-09 |
| 1033281373 | Annie Lincoln | Psychiatry & Neurology | 2310 Indiana Ave, Lubbock, TX 79410-2142 | 2006-11-14 |
| 1649363326 | Health and Human Services Commission | Psychiatry & Neurology | 3401 N University Ave, Lubbock, TX 79415-1734 | 2006-10-02 |
| 1306822242 | Jongyeol Kim | Psychiatry & Neurology | 3601 4th St # Ms 8321, Lubbock, TX 79430-0002 | 2005-12-22 |
| 1619497161 | Smathorn Thakolwiboon | Psychiatry & Neurology | 3601 4th St Stop 8321, Lubbock, TX 79430-8321 | 2017-06-26 |
| 1053831693 | Dargelis Chi | Psychiatry & Neurology | 3601 4th St Stop 8321, Lubbock, TX 79430-8321 | 2017-06-25 |
| 1508310111 | Dongkwan Jin | Psychiatry & Neurology | 3601 4th St, Ttuhsc, Department of Neurology, Lubbock, TX 79430-8321 | 2016-08-11 |
| 1770036881 | Juliana Bertha D Gomez Abanto | Psychiatry & Neurology | 3601 4th St Stop 8321, Lubbock, TX 79430-8321 | 2016-07-26 |
| 1376990986 | Mst Jannatul Ferdous | Psychiatry & Neurology | 3601 4th St, Stop 8321, Lubbock, TX 79430-8321 | 2016-05-24 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.