Provider Demographics
NPI:1134647985
Name:CHEN, CHIYU DAVID
Entity Type:Individual
Prefix:MR
First Name:CHIYU
Middle Name:DAVID
Last Name:CHEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9014 LAKES AT 610 DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-2400
Mailing Address - Country:US
Mailing Address - Phone:832-766-2112
Mailing Address - Fax:
Practice Address - Street 1:2402 SUNSET BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77005-1432
Practice Address - Country:US
Practice Address - Phone:713-777-2100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-31
Last Update Date:2017-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC01678171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist