Individual ProviderNicholas TanStudent in an Organized Health Care Education/Training ProgramStudent, Health CarePractice AddressTtuhsc Department Of Neurology/Division Of Pm&R, 3601 Street, Stop 6211, Lubbock, TX 79430-0001(806) 743-1646PECOS EnrollmentBased on the most recent information from CMS, provider Nicholas Tan does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 4 days ago.Profile DetailsProvider ID1821847674Provider TypeIndividualFull NameTan, NicholasTitleDr.CredentialMDGenderMaleSole ProprietorNoEnumeration Date5/15/2024Last Updated5/15/2024Contact InformationPractice LocationPractice AddressTtuhsc Department Of Neurology/Division Of Pm&R, 3601 Street, Stop 6211, Lubbock, TX 79430-0001Phone(806) 743-1646FaxUnlisted FaxMailing LocationMailing AddressTtuhsc Department Of Neurology/Division Of Pm&R, 3601 Street, Stop 6211, Lubbock, TX 79430-0001PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode390200000XPrimaryDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer