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Individual

FONDA CHAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
8390 LYNDON B JOHNSON FWY STE 1000, DALLAS, TX 75243-1288
(214) 750-9977
(214) 750-9983
Mailing address
80 GARDNER ST APT 11, ALLSTON, MA 02134-2236
(410) 258-8336

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
252590
MA
2084N0400X
Neurology Physician
Primary
R6985
TX

Other

Enumeration date
08/10/2012
Last updated
10/21/2020
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