Provider Demographics
NPI:1093007700
Name:KWAN, JONATHAN KEEWING (MD)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:KEEWING
Last Name:KWAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11834 MOSS BRANCH RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77043-1109
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4301 N MACARTHUR BLVD
Practice Address - Street 2:SUITE 101 (972) 255-5588
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75038-6497
Practice Address - Country:US
Practice Address - Phone:972-855-5588
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-12
Last Update Date:2015-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ4170207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology