Provider Demographics
NPI:1508856659
Name:HAN, NOEL MATHEW (MD)
Entity Type:Individual
Prefix:
First Name:NOEL
Middle Name:MATHEW
Last Name:HAN
Suffix:
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 1:15655 CYPRESS WOODS MEDICAL DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77014
Mailing Address - Country:US
Mailing Address - Phone:281-580-7004
Mailing Address - Fax:281-921-1166
Practice Address - Street 1:15655 CYPRESS WOODS MEDICAL DR
Practice Address - Street 2:SUITE 110
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77014
Practice Address - Country:US
Practice Address - Phone:281-580-7004
Practice Address - Fax:281-921-1166
Is Sole Proprietor?:No
Enumeration Date:2005-10-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ4182207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
87422ZOtherHMO BLUE
80432YOtherBCBS
F93163Medicare UPIN
8525K2Medicare ID - Type Unspecified