Basic Information
Provider Information
NPI: 1164781779
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CAI
FirstName: ZHENJIAN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6431 FANNIN STREET
Address2: MSB 2.136
City: HOUSTON
State: TX
PostalCode: 770301501
CountryCode: US
TelephoneNumber: 7135005301
FaxNumber: 7135000695
Practice Location
Address1: 5656 KELLEY STREET
Address2:  
City: HOUSTON
State: TX
PostalCode: 770261967
CountryCode: US
TelephoneNumber: 7135665234
FaxNumber: 7135000695
Other Information
ProviderEnumerationDate: 05/16/2012
LastUpdateDate: 08/26/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/26/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207ZP0102XR4195TXY Allopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology

No ID Information.


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