Provider Demographics
NPI:1700964103
Name:CHAN, RODNEY K (MD)
Entity Type:Individual
Prefix:DR
First Name:RODNEY
Middle Name:K
Last Name:CHAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:8042 WURZBACH RD
Mailing Address - Street 2:SUITE 130
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3818
Mailing Address - Country:US
Mailing Address - Phone:210-201-2806
Mailing Address - Fax:888-878-2254
Practice Address - Street 1:8042 WURZBACH RD
Practice Address - Street 2:SUITE 130
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3818
Practice Address - Country:US
Practice Address - Phone:210-201-2806
Practice Address - Fax:888-878-2254
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2023-12-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD459490208200000X
TXN43342086S0122X, 208200000X, 2086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ29541Medicare UPIN
MAJ29541Medicare UPIN