Provider Demographics
NPI:1215236799
Name:TAN, WEIYI (MD, MPH)
Entity type:Individual
Prefix:
First Name:WEIYI
Middle Name:
Last Name:TAN
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 845347
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-7208
Mailing Address - Country:US
Mailing Address - Phone:214-645-8000
Mailing Address - Fax:
Practice Address - Street 1:2001 INWOOD ROAD
Practice Address - Street 2:WEST CAMPUS BUILDING 3, 5TH FLOOR
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75390-8358
Practice Address - Country:US
Practice Address - Phone:214-645-8000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-23
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA122835207R00000X, 207RA0002X, 207RI0011X, 207RC0000X, 208000000X
TXT2075207RA0002X, 207RC0000X, 207RI0011X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RA0002XAllopathic & Osteopathic PhysiciansInternal MedicineAdult Congenital Heart DiseaseGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics