Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ethan Matthew Fan

Individual provider Internal Medicine Physician · NPI 1649913138

Ethan Matthew Fan is an Internal Medicine in Dallas, Texas. Qualified in 2022, 4 years ago. Practices with Hospitalist Medicine Physicians of Texas PLLC, a 701-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Texas.

Years since qualifying
4
Licensed in
TX
In the registry since
2022
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Practice location Address checks out

8200 Walnut Hill Ln
Dallas, TX 75231-4402
Phone: (214) 345-6176
Fax: (214) 345-5167
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1140 Peacock Blvd, Carrollton, TX 75007-2943 — (469) 471-4848

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence W0570 (TX)

Record details

NPI number1649913138
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedApril 14, 2022
Last updated in NPPESDecember 9, 2025
Certification dateDecember 9, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyINTERNAL MEDICINE
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Hospitalist Medicine Physicians Of Texas Pllc — 701 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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