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NPI 1053730663

NPI 1053730663 : BO CHEN : HOUSTON, TX

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General NPI Number Information
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    NPI Number           |    1053730663
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    Entity Type          |    Individual 
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    Provider Name        |    BO CHEN
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    04/10/2014
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    Last Update Date     |    01/12/2023
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Provider Practice Location Address
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    Address Line         |    6411 FANNIN ST 
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    City                 |    HOUSTON
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    State                |    TX
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    Zip                  |    77030-1501
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    Country              |    US
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    Telephone            |    713-500-7583
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    6431 FANNIN ST 
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    City                 |    HOUSTON
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    State                |    TX
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    Zip                  |    77030-1501
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    207R00000X
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    Taxonomy Name        |    Internal Medicine Physician
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    License Number       |    BP10049447
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    License Number State |    TX
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Taxonomy #2
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    Taxonomy Code        |    207U00000X
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    Taxonomy Name        |    Nuclear Medicine Physician
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    License Number       |    S2000
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    License Number State |    TX
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Taxonomy #3
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    Taxonomy Code        |    2085R0202X
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    Taxonomy Name        |    Diagnostic Radiology Physician
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    License Number       |    S2000
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    License Number State |    TX
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Taxonomy #4
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    Taxonomy Code        |    390200000X
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    Taxonomy Name        |    Student in an Organized Health Care Education/Training Program
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    License Number       |    
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    License Number State |    
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Taxonomy #5
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    Taxonomy Code        |    2085N0904X
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    Taxonomy Name        |    Nuclear Radiology Physician
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    License Number       |    S2000
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    License Number State |    TX
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