Individual
DR. EULOGIO E TAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
639 LOTUS DR N, SUITE B, MANDEVILLE, LA 70471-2926
(985) 626-6133
(985) 626-6136
Mailing address
5737 SPRUCE ST, LAKE CHARLES, LA 70605-8124
(337) 304-0523
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
03820R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1158224
—
LA
Enumeration date
09/16/2006
Last updated
07/08/2007
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