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NPI Code Detail

MEDICARE: DR. DAVID CHAN DDS

MEDICARE: DR. DAVID CHAN DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist21927TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1326265018
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAVID CHAN DDS
Provider Business Mailing Address
First Line : 12125 HIGHWAY 6 STE D
Second Line :
City : FRESNO
State : TX
Zip : 77545-8844
Country : US
Telephone Number : 281-431-8909
Fax Number :
Provider Business Practice Location Address
First Line : 12125 HIGHWAY 6 STE D
Second Line :
City : FRESNO
State : TX
Zip : 77545-8844
Country : US
Telephone Number : 281-431-8909
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/20/2007
Last Update Date : 08/31/2011

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