Provider Demographics
NPI:1306131966
Name:CHIN, JONATHAN WEILON (MD)
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:WEILON
Last Name:CHIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 W 38TH ST STE 306
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-6406
Mailing Address - Country:US
Mailing Address - Phone:512-846-3100
Mailing Address - Fax:512-846-3101
Practice Address - Street 1:1600 W 38TH ST STE 306
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731
Practice Address - Country:US
Practice Address - Phone:512-963-6566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-12
Last Update Date:2018-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA261976207L00000X
TX557742207L00000X
TXQ8036208VP0000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine