Individual
SIMON S TAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
241 W SOUTHLAKE BLVD STE 140, SOUTHLAKE, TX 76092-7041
(817) 488-0100
(817) 488-4568
Mailing address
241 W SOUTHLAKE BLVD STE 140, SOUTHLAKE, TX 76092-7041
(817) 488-0100
(817) 488-4568
Taxonomy
Speciality
Code
Description
License number
State
2084N0008X
Neuromuscular Medicine (Psychiatry & Neurology) Physician
L2023
TX
2084N0400X
Neurology Physician
Primary
L2023
TX
2084N0600X
Clinical Neurophysiology Physician
L2023
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
151996901
—
TX
Enumeration date
08/19/2006
Last updated
10/17/2025
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