Basic Information
| Provider Information | |||||||||
| NPI: | 1770755308 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HO | ||||||||
| FirstName: | TANG | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6431 FANNIN ST | ||||||||
| Address2: | MSB 5.036 | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770301501 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7135005410 | ||||||||
| FaxNumber: | 7133833727 | ||||||||
| Practice Location | |||||||||
| Address1: | 6400 FANNIN ST | ||||||||
| Address2: | SUITE 2700 | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770301521 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7134865000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/24/2008 | ||||||||
| LastUpdateDate: | 01/04/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207YS0123X | D67277 | MD | N | Allopathic & Osteopathic Physicians | Otolaryngology | Facial Plastic Surgery | 207YS0123X | N3731 | TX | Y | Allopathic & Osteopathic Physicians | Otolaryngology | Facial Plastic Surgery |
ID Information
| ID | Type | State | Issuer | Description | 017691500 | 05 | MD | MEDICAID | 205053601 | 05 | TX | MEDICAID | 8CC320 | 01 | TX | BCBS | OTHER |