MEDICARE: JIE CHEN RDMS, RVT, RDCS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	247200000X	Other Technician	151258

General Provider Information

NPI Number	:	1235060849
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JIE CHEN RDMS, RVT, RDCS

Provider Business Mailing Address
First Line	:	11918 FOUNTAIN BROOK DR
Second Line	:
City	:	PEARLAND
State	:	TX
Zip	:	77584-8494
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11918 FOUNTAIN BROOK DR
Second Line	:
City	:	PEARLAND
State	:	TX
Zip	:	77584-8494
Country	:	US
Telephone Number	:	832-681-1555
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/25/2026
Last Update Date	:	05/25/2026

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