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Individual

DR. CHRISTINE W WAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
3051 E UNIVERSITY BLVD, ODESSA, TX 79762-7902
(432) 362-4376
(432) 362-6308
Mailing address
4222 WENDOVER AVE, SUITE 600, ODESSA, TX 79762-5945
(432) 552-5656
(432) 552-0992

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
K7933
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
8J3981
BLUE CROSS/BLUE SHIELD
TX
Enumeration date
06/09/2005
Last updated
11/12/2007
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