Nicholas Chan
Individual provider Active NPI Dentist · San Benito, TX
NPI 1336076009 · NPPES record last updated Jul 20, 2026
Key facts
- NPI
- 1336076009
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 42597 (TX)
- Practice address
- 1141 US-77 Bus #G
San Benito, TX 78586 - Phone
- (956) 413-7540
- NPI assigned
- May 6, 2026
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 42597 | TX | Yes |
Addresses
Primary practice location
1141 US-77 Bus #G
San Benito, TX 78586
Mailing address
8505 Freeport Pkwy Ste 600
Irving, TX 75063-2549
Other providers in San Benito, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 20, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.