Organization Active NPI

Edward Chan Medical Group LTD, LLP

  • Ophthalmology Physician
  • Houston, TX
National Provider Identifier
1699097741
Registry record updated Feb 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
G4905 Issued in TX
Legal business name
EDWARD CHAN MEDICAL GROUP LTD, LLP
Practice address
7737 Southwest Fwy
Suite 850
Houston, TX 77074-1807
Phone
(713) 271-2271
Fax
(713) 271-2274
NPI assigned
Feb 17, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2010

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

Authorized official

Name
Dr. Edward K Chan, M.D.NPI 1932296928
Title
President
Phone
(713) 271-2271

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X G4905 TX Primary

Addresses

Primary practice location

7737 Southwest Fwy
Suite 850
Houston, TX 77074-1807

Mailing address

7737 Southwest Fwy
Suite 850
Houston, TX 77074-1807
Phone (713) 271-2271

Other identifiers 1

IdentifierTypeStateIssuer
113548503MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101228000258 TX Part B Supplier - Clinic/Group Practice 2668532599 Receives reassigned benefits from 1 practitioner
Practice locations: Sugar Land, TX

National Provider Directory

National Provider Directory

Locations

7737 Southwest Fwy
Ste 850
Houston, TX 77074
Phone (713) 271-2271

7789 Southwest Fwy
Ste 200
Houston, TX 77074
Phone (713) 343-3100

4675 Highway 6
Ste B
Sugar Land, TX 77478
Phone (281) 277-6100

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1266364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1266364800000",
    "number": "1699097741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7737 SOUTHWEST FWY",
            "address_2": "SUITE 850",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770741807",
            "telephone_number": "713-271-2271",
            "fax_number": "713-271-2274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7737 SOUTHWEST FWY",
            "address_2": "SUITE 850",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770741807",
            "telephone_number": "713-271-2271",
            "fax_number": "713-271-2274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWARD CHAN MEDICAL GROUP LTD, LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-17",
        "last_updated": "2010-02-17",
        "status": "A",
        "authorized_official_last_name": "CHAN",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "713-271-2271",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": "G4905",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113548503",
            "state": "TX"
        }
    ],
    "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 Feb 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.