Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | M6564 | TX |
N | 207T00000X | Neurosurgeon | MD426665 | PA |
NPI | 1053331900 |
---|---|
Provider Name | Peng Roc Chen |
First Address | Houston, TX 77030-1541 |
Second Address | Houston, TX 77030-1534 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2006 |
Last Update Date | 30/01/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
183156201 | (05) | TX |
183156202 | (05) | TX |
183156203 | (05) | TX |
183156204 | (05) | TX |
8AA321 | BCBS (01) | TX |
8AR784 | BCBSTX (01) | TX |
I00767 | (02) | |
P00639900 | MEDICARE RR (01) | TX |