Individual
PAUL P PAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
G1141
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100259570A
—
OK
01
—
120957100
FIRSTCARE
—
05
—
124712405
—
TX
05
—
32857055
—
NM
01
—
8A7860
BLUE CROSS
TX
01
—
MDG1141
WORKERS COMPENSATION
TX
Enumeration date
04/01/2006
Last updated
06/11/2008
Update your record
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