Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103G00000X | Clinical Psychologist | 24013 | TX |
N | 103TC0700X | Clinical Psychologist | 24013 | TX |
N | 103TH0100X | Health Service | 24013 | TX |
NPI | 1073627477 |
---|---|
Provider Name | Dr. Gabriel Tan |
First Address | Sugar Land, TX 77478-5613 |
Second Address | Houston, TX 77030-4211 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2006 |
Last Update Date | 08/07/2007 |