Marian E Cordovez-Tan, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

J8970 Issued in TX

Practice address

3220 Central Mall Dr.
Port Arthur, TX 77642

Phone

(409) 729-7900

Fax

(409) 727-5277

NPI assigned

Dec 22, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• Direct secure messaging: mcordoveztan704308@memorialhermann.direct-ci.com

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.

• Marian Tan Medical Group LTD LLP

  • Pediatrics Physician
  • Port Arthur, TX
  • NPI 1710179445
  NPD (past) Authorized official
• Sarah Dubose, Aprn, PLLC

  • Family Nurse Practitioner
  • Port Arthur, TX
  • NPI 1528664562
  NPD (past)

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213660800000",
    "number": "1649257486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3220 CENTRAL MALL DR.",
            "city": "PORT ARTHUR",
            "state": "TX",
            "postal_code": "77642",
            "telephone_number": "409-729-7900",
            "fax_number": "409-727-5277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3220 CENTRAL MALL DR.",
            "city": "PORT ARTHUR",
            "state": "TX",
            "postal_code": "77642",
            "telephone_number": "409-729-7900",
            "fax_number": "409-727-5277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORDOVEZ-TAN",
        "first_name": "MARIAN",
        "middle_name": "E",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-22",
        "last_updated": "2008-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TX",
            "license": "J8970",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "J8970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• April Lynette Colligan, MS, CCC, SLP
• Complete Health Care
• Melody Coons, PHARMD
• Cooper Premier Services LLC
• Anthony Cooper
• Corium Ventures PLLC
• Country Road Emergency Physicians, PLLC
• Barbara Ann Courville, M.B.A.,LPC
• Denise Craig, FNP-C
• Dustin Kyle Craver, PT, DPT

• Pediatrics Physician in Port Arthur, TX
• Providers in Port Arthur, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.