Provider Demographics
NPI:1750314449
Name:CABO CHAN, ALBERTO V JR (MD)
Entity Type:Individual
Prefix:
First Name:ALBERTO
Middle Name:V
Last Name:CABO CHAN
Suffix:JR
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:PO BOX 845347
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-7208
Mailing Address - Country:US
Mailing Address - Phone:214-645-2870
Mailing Address - Fax:214-645-2871
Practice Address - Street 1:5939 HARRY HINES BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75390
Practice Address - Country:US
Practice Address - Phone:214-645-2870
Practice Address - Fax:214-645-2871
Is Sole Proprietor?:No
Enumeration Date:2006-07-08
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND9883207RE0101X
TXP9816207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND169150OtherUCARE #
ND312720600Medicaid
ND3300187OtherMEDICA #
ND44954OtherSIOUX VALLEY #
NDDA9011033712OtherPREFERRED ONE #
ND3300210OtherMEDICA #
ND1658190OtherAMERICA'S PPO/ARAZ #
ND40372OtherLHS #
ND953S5CAOtherMNBS #
ND00N12CAOtherMNBS #
ND12636Medicaid
ND25544OtherNDBS #
ND25338OtherNDBS #
ND25338OtherNDBS #
ND25338Medicare ID - Type UnspecifiedND MEDICARE #
NDP00227188Medicare ID - Type UnspecifiedRR MEDICARE #
ND169150OtherUCARE #
NDDA9011033712OtherPREFERRED ONE #
ND25544Medicare ID - Type UnspecifiedND MEDICARE #
ND312720600Medicaid