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ELLEN FAN M.D. NPI 1134153646


NPI Information

NPI: 1134153646
Provider Name: ELLEN FAN, M.D.
Classification: Psychiatry & Neurology - 2084P0805X
Entity Type: Individual

Specialization: Geriatric Psychiatry

PECOS Registration: Yes

Address:
3308 PRESTON RD
SUITE 350 BOX 242
PLANO, TX
ZIP 75093
Phone: (972) 769-8572
Get Directions

Ellen Fan, M.D. is a geriatric psychiatry psychiatry neurology in Plano, TX with 26 years of experience. The provider is geriatric Psychiatry is a subspecialty with psychiatric expertise in prevention, evaluation, diagnosis and treatment of mental and emotional disorders in the elderly, and improvement of psychiatric care for healthy and ill elderly patients. Ellen Fan, M.D. NPI is 1134153646. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: UNIVERSITY OF TEXAS MEDICAL SCHOOL AT SAN ANTONIO
Graduation Year:1998

The provider's business location address is:

3308 PRESTON RD
SUITE 350 BOX 242
PLANO, TX
ZIP 75093-453
Phone: (972) 769-8572
Fax: (972) 769-8591

The NPI 1134153646 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/10/2006 and was last updated on 6/5/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12084P0805XPsychiatry & NeurologyGeriatric PsychiatryK8897TEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
18E0503MEDICARE PINTEXAS
2H91609MEDICARE UPINTEXAS
3179655901MEDICAIDTEXAS
4TXB100819MEDICARE PINTEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.