Healthcare Provider Details

I. General information

NPI: 1841357589
Provider Name (Legal Business Name): AN THIEN TANG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ANDREW TANG

II. Dates (important events)

Enumeration Date: 01/02/2007
Last Update Date: 04/19/2023
Certification Date: 04/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

545 GULFGATE CENTER MALL
HOUSTON TX
77087-3023
US

IV. Provider business mailing address

4700 MILLENIA BLVD STE 650
ORLANDO FL
32839-6013
US

V. Phone/Fax

Practice location:
  • Phone: 281-846-7209
  • Fax: 833-845-2872
Mailing address:
  • Phone: 407-533-6836
  • Fax: 407-232-9316

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberM5537
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: