Healthcare Provider Details

I. General information

NPI: 1043586175
Provider Name (Legal Business Name): YUE JULIA CHEN M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JULIA CHEN

II. Dates (important events)

Enumeration Date: 03/22/2012
Last Update Date: 08/24/2021
Certification Date: 08/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 BARBARA JORDAN BLVD STE 400
AUSTIN TX
78723-3078
US

IV. Provider business mailing address

1301 BARBARA JORDAN BLVD STE 400
AUSTIN TX
78723-3078
US

V. Phone/Fax

Practice location:
  • Phone: 512-708-1234
  • Fax:
Mailing address:
  • Phone: 512-708-1234
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0120X
TaxonomyPediatric Surgery Physician
License NumberT1321
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: