MEDICARE: DR. STEPHANIE YACHEN CHEN O.D.

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	152WC0802X	Corneal and Contact Management Optometrist	6065T	TX
2	152W00000X	Optometrist	6065	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	8F4937	OTHER	TX	MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1922112507
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHANIE YACHEN CHEN O.D.

Provider Business Mailing Address
First Line	:	7004 CHANDLER DR
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75024-4807
Country	:	US
Telephone Number	:	469-688-0399
Fax Number	:	972-392-0884

Provider Business Practice Location Address
First Line	:	4122 L B J FWY STE 120
Second Line	:
City	:	FARMERS BRANCH
State	:	TX
Zip	:	75244-5703
Country	:	US
Telephone Number	:	972-392-0884
Fax Number	:	972-392-0884

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

Provider Enumeration Date	:	08/19/2006
Last Update Date	:	11/04/2019

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