1932148277 NPI number — WEINA CHEN MD PHD

Table of content: JASMINE ANDERSON (NPI 1952033029)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932148277 NPI number — WEINA CHEN MD PHD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHEN
Provider First Name:
WEINA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD PHD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CHEN
Provider Other First Name:
WEINA
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD PHD
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1932148277
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/21/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
14275 MIDWAY RD
Provider Second Line Business Mailing Address:
SUITE 400
Provider Business Mailing Address City Name:
ADDISON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75001-3614
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
214-932-8255
Provider Business Mailing Address Fax Number:
972-383-2839

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4350 ALPHA RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DALLAS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75244-4404
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
972-404-9345
Provider Business Practice Location Address Fax Number:
972-404-2506
Provider Enumeration Date:
06/05/2006

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: 207ZP0213X , with the licence number:  L5277 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207ZP0102X , with the licence number: L5277 , 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: 1932148277 . This is a "NPI" identifier . This identifiers is of the category "OTHER".




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