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General NPI Number Information
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NPI Number | 1942556485
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Entity Type | Individual
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Provider Name | WINSTON MING TAK CHAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/02/2012
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Last Update Date | 04/24/2023
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Provider Practice Location Address
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Address Line | 1001 N WALDROP DR STE 802
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City | ARLINGTON
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State | TX
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Zip | 76012-4715
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Country | US
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Telephone | 817-960-9138
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Fax | 917-960-0006
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Provider Business Mailing Address
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Address Line | PO BOX 911230
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City | DALLAS
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State | TX
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Zip | 75391-1230
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Country | US
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Telephone | 972-997-8000
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Fax | 972-234-0813
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208C00000X
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Taxonomy Name | Colon & Rectal Surgery Physician
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License Number | Q9310
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | Q9310
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License Number State | TX
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