MEDICARE: REXANNA CHAN D.O

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
1	207V00000X	Obstetrics & Gynecology Physician	BP1-0040929	TX

General Provider Information

NPI Number	:	1871804609
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REXANNA CHAN D.O

Provider Business Mailing Address
First Line	:	3607 BEACON HILL DR
Second Line	:
City	:	PEARLAND
State	:	TX
Zip	:	77584-9406
Country	:	US
Telephone Number	:	832-291-6833
Fax Number	:

Provider Business Practice Location Address
First Line	:	3919 WOODLAWN AVE
Second Line	:
City	:	PASADENA
State	:	TX
Zip	:	77504-1996
Country	:	US
Telephone Number	:	713-941-7721
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/25/2010
Last Update Date	:	09/14/2016

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Directions to “ REXANNA CHAN D.O” Practice Location

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