Provider Demographics
NPI:1407885312
Name:QUAN, ANGEL (MD)
Entity Type:Individual
Prefix:DR
First Name:ANGEL
Middle Name:
Last Name:QUAN
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 1:17070 RED OAK DRIVE
Mailing Address - Street 2:SUITE 402
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77090-2616
Mailing Address - Country:US
Mailing Address - Phone:281-893-9982
Mailing Address - Fax:281-893-5752
Practice Address - Street 1:17070 RED OAK DRIVE
Practice Address - Street 2:SUITE 402
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-2616
Practice Address - Country:US
Practice Address - Phone:281-893-9982
Practice Address - Fax:281-893-5752
Is Sole Proprietor?:No
Enumeration Date:2006-07-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF8296207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0357004801Medicaid
TX0357004801Medicaid
00RE38Medicare ID - Type Unspecified