Healthcare Provider Details

I. General information

NPI: 1770416166
Provider Name (Legal Business Name): XU CHEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12900 E LOOP 1604 N APT 218
UNIVERSAL CITY TX
78148-3171
US

IV. Provider business mailing address

830 NORTH BLVD BOX 2252
UNIVERSAL CITY TX
78148-9998
US

V. Phone/Fax

Practice location:
  • Phone: 210-884-0395
  • Fax:
Mailing address:
  • Phone: 210-884-0395
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMT117343
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: