Organization
JOHOL C CHAN DO PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHOL CHO-HONG CHAN DO (PRESIDENT)
(956) 795-8236
Entity
Organization
Contact information
Practice address
7210 MCPHERSON RD STE 120, LAREDO, TX 78041-6505
(956) 795-8236
(956) 718-6994
Mailing address
PO BOX 450193, LAREDO, TX 78045-0004
(956) 795-8236
(956) 718-6994
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
K1389
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
159242001
—
TX
01
—
D05769
PALMETTO GBA (MEDICARE RAILROAD)
TX
Enumeration date
05/08/2008
Last updated
06/30/2009
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