| Doctor Name: | CHUN WANG Y TAN |
| NPI Number: | 1104825785 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | K3862 |
| Business Practice Address: | 1808 Highway 97 E Jourdanton, TX - 780261535 |
| Business Phone Number: | 8305694003 |
| Business Fax Number: | 8305694001 |
| Mailing Address: | 1808 Highway 97 E, JOURDANTON |
| State: | TX |
| Postal Code: | 780261535 |
| Phone Number: | 8305694003 |
| Fax Number: | 8305694001 |
| NPI Enumeration Date: | 07/18/2005 |
| NPI Last Update Date: | 10/14/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207RC0000X |
| License Number: | K3862 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Internal Medicine |
| Taxonomy Specialization: | Cardiovascular Disease |
| Taxonomy Definition: | An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |