MEDICARE: ALLEN CHEN DDS, P.C.

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	1223G0001X	General Practice Dentistry	19784	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	B19784	OTHER	TX	TEXAS CHIP
2	1303328	OTHER	TX	UNITED CONCORDIA
3	D19784	OTHER	TX	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1598883647
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLEN CHEN DDS, P.C.

Provider Business Mailing Address
First Line	:	4625 AUSTIN PKWY
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-2146
Country	:	US
Telephone Number	:	281-491-8988
Fax Number	:	281-491-8729

Provider Business Practice Location Address
First Line	:	4625 AUSTIN PKWY
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-2146
Country	:	US
Telephone Number	:	281-491-8988
Fax Number	:	281-491-8729

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ALLEN CHEN
Credential	:	D.D.S.
Telephone Number	:	281-491-8988

Provider Enumeration Date	:	03/27/2007
Last Update Date	:	07/10/2008

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