Doctor profile · Federal record
Dr. Ethan Fan
Internal Medicine Physician (CMS: Internal Medicine) · Dallas, TX
- NPI 1649913138
- Accepts Medicare
- 4 yrs in practice
- Male
- Group practice
- No sanctions
Practice & contact
Operates at 2 locations .
- Primary practice
-
8200 Walnut Hill Ln
Dallas, TX 752314402
(214) 345-6176
fax (214) 345-5167 - Additional location
-
1140 Peacock Blvd
Carrollton, TX 750072943
(469) 471-4848 - Mailing address
-
1140 Peacock Blvd
Carrollton, TX 750072943
Credentials & registration
- NPI registered
- April 2022 — 4 yrs on file
- Profile last updated
- December 9, 2025
- Year of graduation
- 2022 — 4 yrs since
- Specialty taxonomy
- 207R00000X — NUCC code
- State license (1)
- Texas #W0570
Federal sanctions & exclusions
No sanctions, exclusions or revocations on file
Checked against OIG LEIE on NPI 1649913138. Last verified May 11, 2026.Open Payments
Industry payments received
All-time total
$114
Transactions
5
Manufacturers
3
| Payer (manufacturer) | Industry | Txns | Amount |
|---|---|---|---|
| Alexion Pharmaceuticals, INC. | 2 | $60.14 | |
| Amgen INC. | 2 | $34.01 | |
| Merck Sharp & Dohme LLC | 1 | $19.97 |
By nature of payment
Medicare Part D · 2023
Top prescriptions
Total claims
26
Patients
0
Total drug cost
$166
| Drug | Type | Claims | Patients | Total cost |
|---|---|---|---|---|
| Pantoprazole Sodium | Generic | 14 | 0 | $114 |
| Atorvastatin Calcium | Generic | 12 | 0 | $52 |
Hospital affiliations
Frequently asked questions
What is Dr. Ethan Fan's medical specialty?
Dr. Ethan Fan practices Internal Medicine Physician in Dallas, TX.
Where does Dr. Ethan Fan practice?
Dr. Ethan Fan practices at 8200 Walnut Hill Ln, Dallas, TX 752314402. Office phone: 2143456176.
What is Dr. Ethan Fan's NPI?
Dr. Ethan Fan's National Provider Identifier (NPI) is 1649913138, issued by NPPES.
Does Dr. Ethan Fan accept Medicare assignment?
Yes. Dr. Ethan Fan accepts Medicare assignment, meaning Medicare-allowed amounts are accepted as full payment for covered services.