Organization
DANIEL T.L. TAN, M.D., P.A.
Active
Other names
Spectrum Psychiatric Services
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL T. L. TAN M.D. (OWNER)
(713) 779-4200
Entity
Organization
Contact information
Practice address
10101 SOUTHWEST FWY, SUITE 510, HOUSTON, TX 77074-1126
(713) 779-4200
(713) 779-5866
Mailing address
10101 SOUTHWEST FWY, SUITE 510, HOUSTON, TX 77074-1126
(713) 779-4200
(713) 779-5866
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
J3241
TX
2084P0804X
Child & Adolescent Psychiatry Physician
J3241
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10017070
AMERIGROUP MEDICAID #
TX
05
—
132061602
—
TX
Enumeration date
01/30/2007
Last updated
08/29/2013
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