Provider Demographics
NPI:1952502999
Name:CHAN, RENEE L (MD)
Entity Type:Individual
Prefix:DR
First Name:RENEE
Middle Name:L
Last Name:CHAN
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:4701 MEDICAL CENTER DR
Mailing Address - Street 2:STE 1-A
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75069-1831
Mailing Address - Country:US
Mailing Address - Phone:214-733-8001
Mailing Address - Fax:972-542-3559
Practice Address - Street 1:4701 MEDICAL CENTER DR
Practice Address - Street 2:STE 1-A
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069-1831
Practice Address - Country:US
Practice Address - Phone:214-733-8001
Practice Address - Fax:972-542-3559
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2011-12-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXM6560207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX179213701Medicaid
TX8J9705Medicare UPIN
TX00707ZMedicare PIN