Provider Demographics
NPI:1538646187
Name:CHAN, ARNEL (FNP)
Entity Type:Individual
Prefix:
First Name:ARNEL
Middle Name:
Last Name:CHAN
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19073 INTERSTATE 45 S STE 115
Mailing Address - Street 2:
Mailing Address - City:SHENANDOAH
Mailing Address - State:TX
Mailing Address - Zip Code:77385-8775
Mailing Address - Country:US
Mailing Address - Phone:936-271-2227
Mailing Address - Fax:936-271-2229
Practice Address - Street 1:19073 INTERSTATE 45 S STE 115
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77385-8775
Practice Address - Country:US
Practice Address - Phone:936-271-2227
Practice Address - Fax:936-271-2229
Is Sole Proprietor?:No
Enumeration Date:2018-07-26
Last Update Date:2018-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP136012363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care