Active NPI
Samuel Gan, M.D.
- Family Medicine Physician
- Houston, TX
National Provider Identifier
1114287935
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- Q1606
- Practice address
- 6918 Corporate Dr A10
Houston, TX 77036-5139 - Phone
- (713) 777-3150
- Fax
- (713) 777-4530
- NPI assigned
- May 26, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Q1606 | TX | Primary |
Addresses
Primary practice location
6918 Corporate Dr A10
Houston, TX 77036-5139
Mailing address
6918 Corporate Dr A10
Houston, TX 77036-5139
Phone (713) 777-3150
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150805006589 | TX | Practitioner - Family Practice | 1557675568 | Practice locations: Bellaire, TX |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| Q1606 | TX | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1337990400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1444089600000",
"number": "1114287935",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6918 CORPORATE DR A10",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770365139",
"telephone_number": "713-777-3150",
"fax_number": "713-777-4530"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6918 CORPORATE DR A10",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770365139",
"telephone_number": "713-777-3150",
"fax_number": "713-777-4530"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAN",
"first_name": "SAMUEL",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-05-26",
"last_updated": "2015-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "TX",
"license": "Q1606",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.