Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 56766 | MN |
N | 111NI0900X | Internist | 56766 | MN |
N | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 56766 | MN |
N | 207RC0000X | Internist - Cardiovascular Disease | 56766 | MN |
Y | 207RC0000X | Internist - Cardiovascular Disease | S7817 | TX |
NPI | 1710241641 |
---|---|
Provider Name | Siu-Hin Wan |
First Address | Dallas, TX 75284-7208 |
Second Address | Dallas, TX 75390-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2012 |
Last Update Date | 10/09/2020 |