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General NPI Number Information
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NPI Number | 1447396726
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Entity Type | Organization
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Legal Business Name | DANIEL T.L. TAN, M.D., P.A.
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 08/29/2013
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Provider Practice Location Address
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Address Line | 10101 SOUTHWEST FWY SUITE 510
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City | HOUSTON
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State | TX
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Zip | 77074-1126
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Country | US
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Telephone | 713-779-4200
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Fax | 713-779-5866
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Provider Business Mailing Address
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Address Line | 10101 SOUTHWEST FWY SUITE 510
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City | HOUSTON
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State | TX
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Zip | 77074-1126
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Country | US
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Telephone | 713-779-4200
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Fax | 713-779-5866
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Authorized Official
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Title or Position | OWNER
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Name | DR. DANIEL T. L. TAN
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Credential | M.D.
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Telephone | 713-779-4200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | J3241
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | J3241
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License Number State | TX
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