Provider Demographics
NPI:1578556700
Name:PANGAN, CHRISTIAN SPENCER (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:SPENCER
Last Name:PANGAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1124 N VELASCO ST
Mailing Address - Street 2:SUITE E
Mailing Address - City:ANGLETON
Mailing Address - State:TX
Mailing Address - Zip Code:77515-3160
Mailing Address - Country:US
Mailing Address - Phone:979-849-8900
Mailing Address - Fax:979-849-9995
Practice Address - Street 1:1124 N VELASCO ST
Practice Address - Street 2:SUITE E
Practice Address - City:ANGLETON
Practice Address - State:TX
Practice Address - Zip Code:77515-3160
Practice Address - Country:US
Practice Address - Phone:979-849-8900
Practice Address - Fax:979-849-9995
Is Sole Proprietor?:No
Enumeration Date:2005-08-23
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9191111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX150560401Medicaid
TX8M2190OtherBCBS
U89574Medicare UPIN
TX150560401Medicaid