Provider Demographics
NPI:1629011440
Name:TAN, HAN L (MD)
Entity Type:Individual
Prefix:DR
First Name:HAN
Middle Name:L
Last Name:TAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JOHN
Other - Middle Name:L
Other - Last Name:TAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:8440 WALNUT HILL LN
Mailing Address - Street 2:SUITE 700
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-3833
Mailing Address - Country:US
Mailing Address - Phone:214-361-3300
Mailing Address - Fax:214-361-3431
Practice Address - Street 1:4510 MEDICAL CENTER DR STE 108
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069-1624
Practice Address - Country:US
Practice Address - Phone:214-726-9292
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK8512207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX141251201Medicaid
88120NMedicare PIN
TX141251201Medicaid
G72604Medicare UPIN
879273Medicare PIN