MEDICARE: HAN CHAN L.AC.

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
1	171100000X	Acupuncturist	AC00292	TX

General Provider Information

NPI Number	:	1376673897
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HAN CHAN L.AC.

Provider Business Mailing Address
First Line	:	2110 JEFFERSON ST STE 105
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77003-5100
Country	:	US
Telephone Number	:	713-222-8118
Fax Number	:	713-222-8118

Provider Business Practice Location Address
First Line	:	2110 JEFFERSON ST STE 105
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77003-5100
Country	:	US
Telephone Number	:	713-222-8118
Fax Number	:	713-222-8118

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/06/2007
Last Update Date	:	07/08/2007

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Directions to “ HAN CHAN L.AC.” Practice Location

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