MEDICARE: KAREN DE LEON CHIN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	M2286	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8M8138	OTHER	TX	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1750355418
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN DE LEON CHIN M.D.

Provider Business Mailing Address
First Line	:	3502 PINNACLE DR
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78261-2352
Country	:	US
Telephone Number	:	210-521-5703
Fax Number	:

Provider Business Practice Location Address
First Line	:	2015 BROADWAY ST
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78215-1117
Country	:	US
Telephone Number	:	210-961-4118
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/16/2006
Last Update Date	:	05/23/2020

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