Provider Demographics
NPI:1376501924
Name:KWAN, KAREN YEH (MD)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:YEH
Last Name:KWAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1441 S MIDLOTHIAN PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:TX
Mailing Address - Zip Code:76065-5591
Mailing Address - Country:US
Mailing Address - Phone:469-800-9600
Mailing Address - Fax:469-800-9610
Practice Address - Street 1:1441 S MIDLOTHIAN PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:MIDLOTHIAN
Practice Address - State:TX
Practice Address - Zip Code:76065-5591
Practice Address - Country:US
Practice Address - Phone:469-800-9600
Practice Address - Fax:469-800-9610
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2015-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK3661207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8M2958OtherBCBS
TX044024005Medicaid
TX044024005Medicaid
TXP00716920Medicare PIN
TX8F3679Medicare PIN
TX8F9775Medicare PIN