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Individual

DR. THOMAS TAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4110 GUADALUPE ST, ATTN: REIMBURSEMENT, AUSTIN, TX 78751-4223
(512) 419-2731
Mailing address
4110 GUADALUPE ST, ATTN: REIMBURSEMENT, AUSTIN, TX 78751-4223

Taxonomy

Speciality
Code
Description
License number
State
2084F0202X
Forensic Psychiatry Physician
E8271
TX
2084P0800X
Psychiatry Physician
Primary
E8271
TX
2084P0804X
Child & Adolescent Psychiatry Physician
E8271
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1163883 02
TX
05
116388301
TX
Enumeration date
10/18/2006
Last updated
12/15/2010
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