Individual
STEPHEN T. PAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12554 RIATA VISTA CIR, AUSTIN, TX 78727-6431
(512) 795-5100
(512) 795-5122
Mailing address
12554 RIATA VISTA CIR, AUSTIN, TX 78727-6431
(512) 795-5100
(512) 795-5122
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
241639
NY
2085R0202X
Diagnostic Radiology Physician
Primary
A111204
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0A1112040
—
CA
Enumeration date
02/24/2010
Last updated
01/13/2015
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