Individual
MASON CHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1100 WILFORD HALL LOOP, JBSA LACKLAND, TX 78236-5638
(210) 292-4277
Mailing address
1100 WILFORD HALL LOOP, JBSA LACKLAND, TX 78236-5638
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
0101279440
VA
Other
Enumeration date
03/22/2022
Last updated
08/24/2023
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