Individual
AUDREY JACQUELINE CHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6701 FANNIN ST, SUITE 670, HOUSTON, TX 77030-2608
(832) 822-3720
Mailing address
7500 KIRBY DR, APT. 633, HOUSTON, TX 77030-4300
(443) 618-1578
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Q0233
TX
207NP0225X
Pediatric Dermatology Physician
Primary
Q0233
TX
208000000X
Pediatrics Physician
Q0233
TX
Other
Enumeration date
04/05/2010
Last updated
08/22/2024
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