MEDICARE: DR. LAN ALBIN NELSON MD

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	2084P0800X	Psychiatry Physician	G0496	TX

Other Identifiers

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

General Provider Information

NPI Number	:	1518051341
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAN ALBIN NELSON MD

Provider Business Mailing Address
First Line	:	70E LAKEVIEW DR
Second Line	:
City	:	POINTBLANK
State	:	TX
Zip	:	77364-6982
Country	:	US
Telephone Number	:	936-377-5451
Fax Number	:

Provider Business Practice Location Address
First Line	:	1221 UNIVERSITY AVE
Second Line	:	SUITE 102
City	:	HUNTSVILLE
State	:	TX
Zip	:	77340-4632
Country	:	US
Telephone Number	:	936-291-6274
Fax Number	:	936-291-6274

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

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	07/08/2015

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