Provider Demographics
NPI:1063829935
Name:CHEN, FELICIA LILY TRAN (OD)
Entity Type:Individual
Prefix:
First Name:FELICIA
Middle Name:LILY TRAN
Last Name:CHEN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9580 OLD KEENE MILL RD
Mailing Address - Street 2:
Mailing Address - City:BURKE
Mailing Address - State:VA
Mailing Address - Zip Code:22015-4208
Mailing Address - Country:US
Mailing Address - Phone:703-337-4830
Mailing Address - Fax:
Practice Address - Street 1:9580 OLD KEENE MILL RD
Practice Address - Street 2:
Practice Address - City:BURKE
Practice Address - State:VA
Practice Address - Zip Code:22015-4208
Practice Address - Country:US
Practice Address - Phone:703-337-4830
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-12
Last Update Date:2017-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618002359152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist