Healthcare Provider Details

I. General information

NPI: 1598966350
Provider Name (Legal Business Name): YETING HELEN CHEN CNIM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1778 N PLANO RD SUITE 112
RICHARDSON TX
75081-1968
US

IV. Provider business mailing address

1319 ELK GROVE DR
RICHARDSON TX
75081-2609
US

V. Phone/Fax

Practice location:
  • Phone: 214-239-1961
  • Fax: 214-561-1641
Mailing address:
  • Phone: 972-680-3362
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2472E0500X
TaxonomyEEG Technician
License Number1131
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: