Organization
MARIAN TAN MEDICAL GROUP LTD LLP
Active
Other names
The Childrens Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARIAN E CORDOVEZ-TAN MD (PHYSICIAN)
(409) 729-7900
Entity
Organization
Contact information
Practice address
3220 CENTRAL MALL DRIVE, PORT ARTHUR, TX 77642
(409) 729-7900
(409) 727-5277
Mailing address
3220 CENTRAL MALL DRIVE, PORT ARTHUR, TX 77642
(409) 729-7900
(409) 727-5277
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
J9870
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0084LT
BLUE CROSS BLUE SHIELD
TX
05
—
111668301
—
TX
05
—
111668302
—
TX
Enumeration date
08/16/2007
Last updated
02/04/2009
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