NPIMap

Organization Active NPI

Marian Tan Medical Group LTD LLP

  • Pediatrics Physician
  • Port Arthur, TX
National Provider Identifier
1710179445
Registry record updated Feb 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
J9870 Issued in TX
Legal business name
MARIAN TAN MEDICAL GROUP LTD LLP
Practice address
3220 Central Mall Drive
Port Arthur, TX 77642
Phone
(409) 729-7900
Fax
(409) 727-5277
NPI assigned
Aug 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2009

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

Authorized official

Name
Mrs. Marian E Cordovez-Tan, MDNPI 1649257486
Title
Physician
Phone
(409) 729-7900

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
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X J9870 TX Primary

Addresses

Primary practice location

3220 Central Mall Drive
Port Arthur, TX 77642

Mailing address

3220 Central Mall Drive
Port Arthur, TX 77642
Phone (409) 729-7900

Other identifiers 3

IdentifierTypeStateIssuer
111668301MedicaidTX
111668302MedicaidTX
0084LTOtherTXBLUE CROSS BLUE SHIELD

Other names 1

  • The Childrens Health Center Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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": "1187222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233705600000",
    "number": "1710179445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3220 CENTRAL MALL DRIVE",
            "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 DRIVE",
            "city": "PORT ARTHUR",
            "state": "TX",
            "postal_code": "77642",
            "telephone_number": "409-729-7900",
            "fax_number": "409-727-5277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIAN TAN MEDICAL GROUP LTD LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-16",
        "last_updated": "2009-02-04",
        "status": "A",
        "authorized_official_last_name": "CORDOVEZ-TAN",
        "authorized_official_first_name": "MARIAN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "409-729-7900",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "J9870",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111668301",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111668302",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0084LT",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Childrens Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Port Arthur, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2009; 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.