Provider Demographics
NPI:1821376245
Name:VAN, AN (MD)
Entity Type:Individual
Prefix:DR
First Name:AN
Middle Name:
Last Name:VAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ANTOINE
Other - Middle Name:
Other - Last Name:VAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:7200 CAMBRIDGE ST FL 10
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-4202
Mailing Address - Country:US
Mailing Address - Phone:713-798-1750
Mailing Address - Fax:713-798-4693
Practice Address - Street 1:7200 CAMBRIDGE ST FL 10
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-4202
Practice Address - Country:US
Practice Address - Phone:713-798-1750
Practice Address - Fax:713-798-4693
Is Sole Proprietor?:No
Enumeration Date:2011-08-02
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX558983207L00000X
TXQ4869207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology