Individual
DR. KA WAH CHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4410 MEDICAL DR, SUITE 550, SAN ANTONIO, TX 78229-6306
(210) 575-2222
(210) 575-6373
Mailing address
8109 FREDERICKSBURG RD, PHYSICIAN PRACTICE SERVICES, SAN ANTONIO, TX 78229-3311
(210) 575-2222
(210) 575-6373
Taxonomy
Speciality
Code
Description
License number
State
207RH0000X
Hematology (Internal Medicine) Physician
J2535
TX
208000000X
Pediatrics Physician
J2535
TX
2080P0203X
Pediatric Critical Care Medicine Physician
J2535
TX
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
J2535
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
130467713
—
TX
01
—
130467714
CSN
TX
01
—
8CC910
BCBS
—
Enumeration date
04/26/2006
Last updated
05/26/2014
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