Healthcare Provider Details

I. General information

NPI: 1790219087
Provider Name (Legal Business Name): JUSTINE M CHEN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2017
Last Update Date: 02/15/2024
Certification Date: 02/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6400 FANNIN ST., STE 2800
HOUSTON TX
77030
US

IV. Provider business mailing address

6400 FANNIN ST., STE 2070
HOUSTON TX
77030
US

V. Phone/Fax

Practice location:
  • Phone: 713-486-8000
  • Fax: 713-486-8088
Mailing address:
  • Phone: 713-486-8000
  • Fax: 713-486-8088

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberT0746
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: