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NPI Code Detail

MEDICARE: RAY CHAN M.D. PLLC

MEDICARE: RAY CHAN M.D. PLLC
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
1261QS0132XOphthalmologic Surgery Clinic/CenterK0439TX

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 : 1902174485
Entity Type Code : Organization
Provider Name (Legal Business Name) : RAY CHAN M.D. PLLC
Provider Business Mailing Address
First Line : 1329 E PIONEER PKWY
Second Line :
City : ARLINGTON
State : TX
Zip : 76010-5868
Country : US
Telephone Number : 817-265-2672
Fax Number : 817-801-5933
Provider Business Practice Location Address
First Line : 1329 E PIONEER PKWY
Second Line :
City : ARLINGTON
State : TX
Zip : 76010-5868
Country : US
Telephone Number : 817-265-2672
Fax Number : 817-801-5933
Authorized Official
Title or Position : PRESIDENT
Name : DR. RAY CHAN
Credential : M.D.
Telephone Number : 817-265-2672
Provider Enumeration Date : 12/12/2011
Last Update Date : 12/12/2011

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