Doctor Name: | DR. ERLINDA M TAN |
NPI Number: | 1124126305 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | E 8954 |
Business Practice Address: | 2495 Shreveport Hwy Pineville, LA - 713604044 |
Business Phone Number: | 3184730010 |
Business Fax Number: | |
Mailing Address: | Po Box 11664, ALEXANDRIA |
State: | LA |
Postal Code: | 713151664 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 09/20/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | E 8954 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |