MEDICARE: PATRICK KWAN M D P A

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	261QR1300X	Rural Health Clinic/Center	G2415	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0050PU	OTHER	TX	BC/BS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	106022	OTHER	TX	CHIP SUPERIOR

General Provider Information

NPI Number	:	1497868293
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PATRICK KWAN M D P A

Provider Business Mailing Address
First Line	:	801 N GRAND AVE
Second Line	:	STE 4
City	:	GAINESVILLE
State	:	TX
Zip	:	76240-3574
Country	:	US
Telephone Number	:	940-665-0683
Fax Number	:	940-668-2663

Provider Business Practice Location Address
First Line	:	801 N GRAND AVE
Second Line	:	STE 4
City	:	GAINESVILLE
State	:	TX
Zip	:	76240-3574
Country	:	US
Telephone Number	:	940-665-0683
Fax Number	:	940-668-2663

Authorized Official
Title or Position	:	OWNER
Name	:	PATRICK K KWAN
Credential	:	M. D.
Telephone Number	:	940-665-0683

Provider Enumeration Date	:	08/16/2006
Last Update Date	:	08/13/2010

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Directions to “PATRICK KWAN M D P A ” Practice Location

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