Active NPI
Kin Yee Chan, M.D.
- Family Medicine Physician
- Houston, TX
National Provider Identifier
1770584385
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- H7954
- Practice address
- 907 Bay Area Blvd
Suite B
Houston, TX 77058-2603 - Phone
- (281) 286-6000
- NPI assigned
- Aug 4, 2005
- Last updated
- Jul 10, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | H7954 | TX | Primary |
Addresses
Primary practice location
907 Bay Area Blvd
Suite B
Houston, TX 77058-2603
Mailing address
907 Bay Area Blvd
Suite B
Houston, TX 77058-2603
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P000J26J | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| H7954 | TX | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Space Center Primary Care, PLLC | Current | Accepting new patients | |
| Kin Yee Chan | Family Medicine | Past | Accepting new patients |
Locations
907 Bay Area Blvd
Ste B
Houston, TX 77058
Phone (281) 286-6000
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Primary Care Clinic/Center
- Houston, TX
- NPI 1033661715
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1123113600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184025600000",
"number": "1770584385",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "907 BAY AREA BLVD",
"address_2": "SUITE B",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770582603"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "907 BAY AREA BLVD",
"address_2": "SUITE B",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770582603",
"telephone_number": "281-286-6000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAN",
"first_name": "KIN",
"middle_name": "YEE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-08-04",
"last_updated": "2007-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "TX",
"license": "H7954",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "P000J26J",
"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 Jul 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.