Provider Demographics
NPI:1962669515
Name:CHAN, CONNER (MD)
Entity Type:Individual
Prefix:
First Name:CONNER
Middle Name:
Last Name:CHAN
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:3730 EMMETT HUTTO BLVD
Mailing Address - Street 2:
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77521-1764
Mailing Address - Country:US
Mailing Address - Phone:281-425-9375
Mailing Address - Fax:281-427-4584
Practice Address - Street 1:3730 EMMETT HUTTO BLVD
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77521-1764
Practice Address - Country:US
Practice Address - Phone:281-425-9375
Practice Address - Fax:281-427-4584
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-21
Last Update Date:2020-05-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXP2424207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology