| Ellen Fan M D P A | |
|
1301 Richardson Dr Richardson TX 75080-4648 | |
| (972) 769-8572 | |
| (972) 769-8591 |
| Full Name | Ellen Fan M D P A |
|---|---|
| Speciality | Psychiatry & Neurology - Geriatric Psychiatry |
| Location | 1301 Richardson Dr, Richardson, Texas |
| Authorized Official Name and Position | Ellen Fan (PHYSICIAN) |
| Authorized Official Contact | 9727698572 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ellen Fan M D P A 3308 Preston Rd Suite 350 Box 242 Plano TX 75093-7453 Ph: (972) 769-8572 | Ellen Fan M D P A 1301 Richardson Dr Richardson TX 75080-4648 Ph: (972) 769-8572 |
| NPI Number | 1467890178 |
|---|---|
| Provider Enumeration Date | 06/05/2013 |
| Last Update Date | 06/05/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467890178 | NPI | - | NPPES |
| 179654201 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0805X | Psychiatry & Neurology - Geriatric Psychiatry | K8897 (Texas) | Primary |
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