Provider Demographics
NPI:1679751259
Name:CHAN, HONG PETER (DC)
Entity type:Individual
Prefix:DR
First Name:HONG
Middle Name:PETER
Last Name:CHAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:11221 RICHMOND AVE
Mailing Address - Street 2:C110
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-6655
Mailing Address - Country:US
Mailing Address - Phone:281-848-1416
Mailing Address - Fax:281-920-4599
Practice Address - Street 1:11221 RICHMOND AVE
Practice Address - Street 2:C110
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-6655
Practice Address - Country:US
Practice Address - Phone:281-848-1416
Practice Address - Fax:281-920-4599
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-05
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX8129111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX610287Medicare PIN