Provider Demographics
NPI:1073802765
Name:PAN, ASHLEY CHARTER (MD)
Entity Type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:CHARTER
Last Name:PAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ASHLEY
Other - Middle Name:ELIZABETH
Other - Last Name:CHARTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:25282 NORTHWEST FWY STE 200
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-1083
Mailing Address - Country:US
Mailing Address - Phone:281-737-2165
Mailing Address - Fax:
Practice Address - Street 1:25282 NORTHWEST FWY STE 200
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-1083
Practice Address - Country:US
Practice Address - Phone:281-737-2165
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-04
Last Update Date:2019-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ3937207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine