Individual ProviderEdward ChanThoracic Surgery (Cardiothoracic Vascular Surgery)Allopathic & Osteopathic PhysiciansPractice Address6550 Fannin St, Suite 1601, Houston, TX 77030-2717(713) 441-5141PECOS EnrollmentBased on the most recent information from CMS, provider Edward Chan is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1831357292Provider TypeIndividualFull NameChan, EdwardCredentialMDGenderMaleSole ProprietorNoEnumeration Date6/1/2008Last Updated10/20/2017Contact InformationPractice LocationPractice Address6550 Fannin St, Suite 1601, Houston, TX 77030-2717Phone(713) 441-5141Fax(713) 790-6470Mailing LocationMailing Address6550 Fannin St, Suite 1601, Houston, TX 77030-2717Phone(713) 441-5141Fax(713) 790-6470Provider TaxonomiesCodeDescriptionLicenseCode208G00000XPrimaryDescriptionThoracic Surgery (Cardiothoracic Vascular Surgery)Allopathic & Osteopathic PhysiciansLicenseQ5986TexasCode208G00000XDescriptionThoracic Surgery (Cardiothoracic Vascular Surgery)Allopathic & Osteopathic PhysiciansLicense60364515WashingtonProvider IdentifiersIDDescriptionIssuerID352687301DescriptionMedicaidIssuerUnlistedTexasID8GD799DescriptionOtherIssuerBCBSTexasID8FL015DescriptionOtherIssuerBCBSTexasID352687302DescriptionMedicaidIssuerUnlistedTexas