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Individual

DR. DANIEL L IVAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
6431 FANNIN ST, JJL 495, HOUSTON, TX 77030-1501
(713) 500-5666
(713) 500-0527
Mailing address
6431 FANNIN ST, JJL 495, HOUSTON, TX 77030-1501
(713) 500-5666
(713) 500-0527

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
4301078858
MI
208000000X
Pediatrics Physician
Primary
N6380
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4609698
MI
Enumeration date
02/13/2006
Last updated
03/14/2012
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