Provider Demographics
NPI:1154315349
Name:TANG, DENNIS (MD)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:
Last Name:TANG
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 1:450 W MEDICAL CENTER BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-4233
Mailing Address - Country:US
Mailing Address - Phone:281-316-6064
Mailing Address - Fax:281-316-6242
Practice Address - Street 1:450 W MEDICAL CENTER BLVD STE 400
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4233
Practice Address - Country:US
Practice Address - Phone:281-316-6064
Practice Address - Fax:281-316-6242
Is Sole Proprietor?:No
Enumeration Date:2005-09-02
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ7859207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8F6726OtherBCBS
TX045342502Medicaid
TX110246153OtherRAILROAD MEDICARE
TX5580763OtherAETNA
TX87608ZOtherHMO BLUE
TX8F6726OtherBCBS
TX87608ZOtherHMO BLUE