Provider Demographics
NPI:1841847191
Name:CHAN, JAY (PT)
Entity type:Individual
Prefix:
First Name:JAY
Middle Name:
Last Name:CHAN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4700 SETON CENTER PKWY STE 115
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-5753
Mailing Address - Country:US
Mailing Address - Phone:903-939-7500
Mailing Address - Fax:
Practice Address - Street 1:22485 TOMBALL PKWY STE 2100
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-1560
Practice Address - Country:US
Practice Address - Phone:281-955-2650
Practice Address - Fax:281-955-5875
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-21
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT297053225100000X
TX1363133225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist