Basic Information
| Provider Information | |||||||||
| NPI: | 1306173091 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LIN | ||||||||
| FirstName: | JAY | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | ONE BAYLOR PLAZA, MS360 | ||||||||
| Address2: | BAYLOR COLLEGE OF MEDICINE, DEPARTMENT OF RADIOLOGY | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 77030 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7137986187 | ||||||||
| FaxNumber: | 7137988050 | ||||||||
| Practice Location | |||||||||
| Address1: | ONE BAYLOR PLAZA, MS360 | ||||||||
| Address2: | BAYLOR COLLEGE OF MEDICINE, DEPARTMENT OF RADIOLOGY | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 77030 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7137986187 | ||||||||
| FaxNumber: | 7137988050 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/17/2009 | ||||||||
| LastUpdateDate: | 12/27/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | 50683 | MN | Y | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | 2085R0202X | N5809 | TX | N | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | 2085R0202X | A116175 | CA | N | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
No ID Information.