Raphael Kok Chin Chan, MD

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

G5874 Issued in TX

Practice address

2615 Fannin St
Houston, TX 77002-9224

Phone

(713) 228-9411

NPI assigned

Jun 26, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Vincent F Honrubia

  • Specialist
  • McAllen, TX
  • NPI 1013913888
  Medicare reassignment NPD
• Imperial Health LLP

  • Family Medicine Physician
  • Lake Charles, LA
  • NPI 1326396375
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1285661587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6363 DEZAVALA ST",
            "address_2": "SUITE 200",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782492104",
            "telephone_number": "210-225-5666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2615 FANNIN ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770029224",
            "telephone_number": "713-228-9411"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 Dr Michael DeBakey Dr",
            "address_purpose": "LOCATION",
            "city": "Lake Charles",
            "state": "LA",
            "postal_code": "706015724",
            "country_code": "US",
            "telephone_number": "337-433-8400",
            "fax_number": "337-312-6813",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAN",
        "first_name": "RAPHAEL",
        "middle_name": "KOK CHIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MN",
            "license": "61523",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "TX",
            "license": "G5874",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1781355",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael M Chan, DDS
• Michelle Chan
• Peter Chan, FNP-C
• Peter Kit Chun Chan, DDS
• Rachel S Chan, DMD
• See Wai Chan, MD
• Sorithea Chan, PHARM.D
• Terence Song-Yang Chan, D.D.S.
• Tiffany Michelle Chan
• Toi Nei Chan, CRNA

• Otolaryngology Physician in Houston, TX
• Providers in Houston, TX by specialty
• Otolaryngology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.

Verify at the official NPI Registry.