Provider Demographics
NPI:1376673897
Name:CHAN, HAN (LAC)
Entity Type:Individual
Prefix:
First Name:HAN
Middle Name:
Last Name:CHAN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2110 JEFFERSON ST STE 105
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77003-5100
Mailing Address - Country:US
Mailing Address - Phone:713-222-8118
Mailing Address - Fax:713-222-8118
Practice Address - Street 1:2110 JEFFERSON ST STE 105
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77003-5100
Practice Address - Country:US
Practice Address - Phone:713-222-8118
Practice Address - Fax:713-222-8118
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC00292171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist