Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | K8723 | TX |
NPI | 1114979309 |
---|---|
Provider Name | Kwai-Tung Chan |
First Address | Houston, TX 77030-2400 |
Second Address | Houston, TX 77030-2348 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H01504 | (02) | CA |