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General NPI Number Information
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NPI Number | 1407199664
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Entity Type | Organization
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Legal Business Name | LONGVIEW PEDIATRICS, PLLC
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Dates
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Enumeration Date | 04/05/2013
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Last Update Date | 04/05/2013
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Provider Practice Location Address
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Address Line | 1009 N 4TH ST STE B
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City | LONGVIEW
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State | TX
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Zip | 75601-4768
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Country | US
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Telephone | 903-212-4330
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Fax | 903-212-4333
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Provider Business Mailing Address
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Address Line | 1009 N 4TH ST STE B
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City | LONGVIEW
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State | TX
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Zip | 75601-4768
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Country | US
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Telephone | 903-212-4330
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Fax | 903-212-4333
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Authorized Official
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Title or Position | MD
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Name | DR. ERIC CHEN
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Credential | MD
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Telephone | 903-212-4330
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | M6080
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License Number State | TX
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