Basic Information
Provider Information
NPI: 1669799490
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHEN
FirstName: JOY
MiddleName: LO
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: CHEN
OtherFirstName: JOY
OtherMiddleName: JU
OtherNamePrefix: MRS.
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: PO BOX 845347
Address2:  
City: DALLAS
State: TX
PostalCode: 752845347
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 5323 HARRY HINES BLVD
Address2: GRADUATE MEDICAL EDUCATION
City: DALLAS
State: TX
PostalCode: 753907201
CountryCode: US
TelephoneNumber: 2145908058
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/04/2010
LastUpdateDate: 09/17/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207LC0200XQ2528TXY Allopathic & Osteopathic PhysiciansAnesthesiologyCritical Care Medicine

No ID Information.


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