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NPI Code Detail

MEDICARE: SIMEON MINGTACK KWAN DO

MEDICARE: SIMEON MINGTACK KWAN DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207QH0002XHospice and Palliative Medicine (Family Medicine) Physician307102LA
2207QH0002XHospice and Palliative Medicine (Family Medicine) Physician008714AZ
3207QH0002XHospice and Palliative Medicine (Family Medicine) PhysicianDO2021-0022NM
4207QH0002XHospice and Palliative Medicine (Family Medicine) Physician104072MT
5207QH0002XHospice and Palliative Medicine (Family Medicine) PhysicianDO200808OR
6207QH0002XHospice and Palliative Medicine (Family Medicine) Physician20658CA
7207QH0002XHospice and Palliative Medicine (Family Medicine) Physician126216AK
8207QH0002XHospice and Palliative Medicine (Family Medicine) Physician12603369-1204UT
9207QH0002XHospice and Palliative Medicine (Family Medicine) PhysicianCDR.0000536CO
10207QH0002XHospice and Palliative Medicine (Family Medicine) PhysicianOP61036685WA
11207QH0002XHospice and Palliative Medicine (Family Medicine) PhysicianCL0088NV
12207Q00000XFamily Medicine PhysicianP4880TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1508154543
Entity Type Code : Individual
Provider Name (Legal Business Name) : SIMEON MINGTACK KWAN DO
Provider Business Mailing Address
First Line : 22 CENTURY BLVD STE 220
Second Line :
City : NASHVILLE
State : TN
Zip : 37214-3787
Country : US
Telephone Number : 615-454-9850
Fax Number :
Provider Business Practice Location Address
First Line : 5444 WESTHEIMER RD STE 1000
Second Line :
City : HOUSTON
State : TX
Zip : 77056-5318
Country : US
Telephone Number : 832-786-4970
Fax Number : 855-722-0157
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2011
Last Update Date : 06/22/2023

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Directions to “ SIMEON MINGTACK KWAN DO” Practice Location

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