Provider Demographics
NPI:1164942348
Name:CHEN, STEPHANIE Y (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:Y
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 1:18100 HOUSTON METHODIST DR STE 220
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-3653
Mailing Address - Country:US
Mailing Address - Phone:832-783-1170
Mailing Address - Fax:281-333-0145
Practice Address - Street 1:18100 HOUSTON METHODIST DR STE 220
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-3653
Practice Address - Country:US
Practice Address - Phone:832-783-1170
Practice Address - Fax:281-333-0145
Is Sole Proprietor?:No
Enumeration Date:2017-06-20
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA91604207Y00000X, 207YX0007X
TXU4768207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & Neck
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU4768OtherTEXAS MEDICAL LICENSE
GA91604OtherSTATE OF GEORGIA LICENSE- GEORGIA COMPOSITE MEDICAL BOARD
GAFC1470537OtherDEA