Provider Demographics
NPI:1467490060
Name:TSAN, LINH HO (PA)
Entity Type:Individual
Prefix:
First Name:LINH
Middle Name:HO
Last Name:TSAN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:LINH
Other - Middle Name:BOI
Other - Last Name:HO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:1111 RAINTREE CIR STE 205
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-4901
Mailing Address - Country:US
Mailing Address - Phone:469-854-6697
Mailing Address - Fax:469-854-6704
Practice Address - Street 1:1111 RAINTREE CIR STE 205
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-4901
Practice Address - Country:US
Practice Address - Phone:469-854-6697
Practice Address - Fax:469-854-6704
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA10668363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
INP00343292OtherMEDICARE RAILROAD
IN000000496064OtherANTHEM BCBC
IN000000496064OtherANTHEM BCBC
IN233680BMedicare PIN