Individual
EDWARD H TAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
J5034
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0071EY
BLUE CROSS
TX
05
—
131136703
—
TX
01
—
8F23844
MEDICARE
TX
Enumeration date
05/06/2006
Last updated
03/22/2010
Update your record
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