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General NPI Number Information
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NPI Number | 1366689879
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Entity Type | Organization
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Legal Business Name | PACHIE SABUGA CHAN M.D.P.A
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Dates
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Enumeration Date | 01/21/2009
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Last Update Date | 01/21/2009
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Provider Practice Location Address
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Address Line | 19073 INTERSTATE 45 S SUITE 115
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City | SHENANDOAH
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State | TX
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Zip | 77385-8743
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Country | US
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Telephone | 936-271-2227
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Fax | 936-271-2229
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Provider Business Mailing Address
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Address Line | 19073 INTERSTATE 45 S SUITE 115
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City | SHENANDOAH
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State | TX
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Zip | 77385-8743
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Country | US
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Telephone | 936-271-2227
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Fax | 936-271-2229
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. PACHIE SABUGA CHAN
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Credential | M.D.
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Telephone | 936-271-2227
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | K6286
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License Number State | TX
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