Provider Demographics
NPI:1770584385
Name:CHAN, KIN YEE (MD)
Entity type:Individual
Prefix:DR
First Name:KIN
Middle Name:YEE
Last Name:CHAN
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 1:907 BAY AREA BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-2603
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:907 BAY AREA BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-2603
Practice Address - Country:US
Practice Address - Phone:281-286-6000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-04
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH7954207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP000J26JMedicaid
TX00J26JMedicare ID - Type Unspecified
TXF02298Medicare UPIN