Healthcare Provider Details

I. General information

NPI: 1356391205
Provider Name (Legal Business Name): SHU-CHIN KUAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 07/11/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21234 KINGSLAND BLVD
KATY TX
77450
US

IV. Provider business mailing address

565 S MASON RD
KATY TX
77450-2437
US

V. Phone/Fax

Practice location:
  • Phone: 281-578-7075
  • Fax: 281-578-7626
Mailing address:
  • Phone: 281-578-7075
  • Fax: 281-578-7626

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberK2519
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: