Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0100X | Occupational Health | MT121111 | TX |
NPI | 1104213198 |
---|---|
Provider Name | Ping Chen |
First Address | Spring, TX 77388 |
Second Address | Spring, TX 77388-6038 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2015 |
Last Update Date | 17/04/2015 |