1801899737 NPI number — DR. YONGXIN CHEN M.D.

Table of content: DR. YONGXIN CHEN M.D. (NPI 1801899737)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801899737 NPI number — DR. YONGXIN CHEN M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHEN
Provider First Name:
YONGXIN
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1801899737
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/23/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12606 W HOUSTON CENTER BLVD STE 260
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77082-2790
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-596-8526
Provider Business Mailing Address Fax Number:
713-596-8560

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
21820 KINGSLAND BLVD
Provider Second Line Business Practice Location Address:
#110
Provider Business Practice Location Address City Name:
KATY
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77450-2508
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-578-7922
Provider Business Practice Location Address Fax Number:
281-578-3175
Provider Enumeration Date:
05/24/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207K00000X , with the licence number:  K8070 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 4206496 . This is a "BLE LINK" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 7501007 . This is a "AETNA PPO" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 2220589 . This is a "AETNA HMO" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 7583192010 . This is a "CIGNA HMO" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 044758301 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 030004687 . This is a "R.R. MEDICARE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 7583192009 . This is a "CIGNA PPO" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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