Provider Demographics
NPI:1114006707
Name:CHEN, LILLY L (MD)
Entity Type:Individual
Prefix:
First Name:LILLY
Middle Name:L
Last Name:CHEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:218 W NASA RD 1
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-5208
Mailing Address - Country:US
Mailing Address - Phone:281-332-4848
Mailing Address - Fax:281-338-1428
Practice Address - Street 1:218 W NASA RD 1
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-5208
Practice Address - Country:US
Practice Address - Phone:281-332-4848
Practice Address - Fax:281-338-1428
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2014-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ52832084N0400X, 208100000X, 2084P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No2084P2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX135864002Medicaid
TXF90857Medicare UPIN
TX135864002Medicaid