Tan, Domingo K

Tan, Domingo K is an individual health care provider with primary practice located at 6100 Harris Parkway, Suite 270 , Fort Worth TX 76132-4132. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Tan, Domingo K can be contacted via phone (817) 433-5658.

Contact Information

Primary practice address
6100 Harris Parkway, Suite 270 Fort Worth TX 76132-4132
Phone: (817) 433-5658
Fax: (817) 570-0173
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X H0872 Texas

Profile Details

NPI number 1982621595
LBN Legal business name Tan, Domingo K
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 17th, 2006
Last updated Dec 31st, 2015 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1982621595 NPPES
Other 020054588 RAILROAD MEDICARE
MEDICAID 113676406 RAILROAD MEDICARE

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