Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | J0874 | TX |
N | 111NI0900X | Internist | J0874 | TX |
Y | 207RR0500X | Rheumatology | J0874 | TX |
NPI | 1083632319 |
---|---|
Provider Name | Filemon K Tan |
First Address | Houston, TX 77216-1088 |
Second Address | Houston, TX 77030-3000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2006 |
Last Update Date | 12/02/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
84250K | BCBS (01) | TX |
F74855 | (02) | TX |