Provider Demographics
NPI:1386734846
Name:CHAN, CHI OI JOYCE (OD)
Entity type:Individual
Prefix:
First Name:CHI OI
Middle Name:JOYCE
Last Name:CHAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:JOYCE
Other - Middle Name:CHI OI
Other - Last Name:CHAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:4546 HOGAN DR.
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78413-2134
Mailing Address - Country:US
Mailing Address - Phone:361-728-9085
Mailing Address - Fax:361-994-1159
Practice Address - Street 1:5488 S. PADRE ISLAND DR.
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411
Practice Address - Country:US
Practice Address - Phone:361-994-1159
Practice Address - Fax:361-994-1159
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5683T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX221343OtherEYEMED PIN