Provider Demographics
NPI:1003585597
Name:CHEN, GRACE AN (PA-C)
Entity Type:Individual
Prefix:
First Name:GRACE
Middle Name:AN
Last Name:CHEN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9731 HAVEN CROSSING CT
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77065-4082
Mailing Address - Country:US
Mailing Address - Phone:832-877-9642
Mailing Address - Fax:
Practice Address - Street 1:22659 HIGHWAY 59 N STE 140
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-4504
Practice Address - Country:US
Practice Address - Phone:281-973-4159
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-08
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA14706363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical