Organization
JEANETTE TAN, MD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEANETTE TAN MD (PRESIDENT)
(915) 592-6868
Entity
Organization
Contact information
Practice address
7812 GATEWAY BLVD E, STE 200, EL PASO, TX 79915-1803
(915) 592-6868
(915) 592-6889
Mailing address
7812 GATEWAY BLVD E, STE 200, EL PASO, TX 79915-1803
(915) 592-6868
(915) 592-6889
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
J9375
TX
207RP1001X
Pulmonary Disease Physician
Primary
J9375
TX
207RS0012X
Sleep Medicine (Internal Medicine) Physician
J9375
TX
Other
Enumeration date
01/29/2007
Last updated
04/13/2011
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