Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | AP136932 | TX |
NPI | 1033612015 |
---|---|
Provider Name | Michael Chen |
First Address | Spring, TX 77379-2923 |
Second Address | Houston, TX 77007-9001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/03/2018 |
Last Update Date | 23/03/2021 |