| Samuel C. Chan, D.o., P.a. | |
|
5787 S Hampton Rd Suite 300, Lb 134 Dallas TX 75232-2255 | |
| (214) 330-3034 | |
| (214) 330-3096 |
| Full Name | Samuel C. Chan, D.o., P.a. |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 5787 S Hampton Rd, Dallas, Texas |
| Authorized Official Name and Position | Samuel C. Chan (PRESIDENT) |
| Authorized Official Contact | 2143303034 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Samuel C. Chan, D.o., P.a. 5787 S Hampton Rd Suite 300, Lb 134 Dallas TX 75232-2255 Ph: (214) 330-3034 | Samuel C. Chan, D.o., P.a. 5787 S Hampton Rd Suite 300, Lb 134 Dallas TX 75232-2255 Ph: (214) 330-3034 |
| NPI Number | 1881656791 |
|---|---|
| Provider Enumeration Date | 04/05/2006 |
| Last Update Date | 05/12/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881656791 | NPI | - | NPPES |
| 079946202 | Medicaid | TX | |
| 00128N | Other | TX | MEDICARE PTAN |
| 5900480001 | Other | TX | PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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