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Individual

CHUN WANG Y TAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1808 HIGHWAY 97 E, JOURDANTON, TX 78026-1535
(830) 569-4003
(830) 569-4001
Mailing address
1808 HIGHWAY 97 E, JOURDANTON, TX 78026-1535
(830) 569-4003
(830) 569-4001

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
K3862
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
037007401
TX
05
037007403
TX
01
8028M0
BCBS
TX
01
8G9388
BCBS
TX
Enumeration date
07/18/2005
Last updated
10/14/2015
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