Provider Demographics
NPI:1285680413
Name:CHEN, EUGENE (OD)
Entity Type:Individual
Prefix:
First Name:EUGENE
Middle Name:
Last Name:CHEN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5920 CRIPPLE CREEK TRL
Mailing Address - Street 2:
Mailing Address - City:NORTH RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76180-0215
Mailing Address - Country:US
Mailing Address - Phone:832-606-3762
Mailing Address - Fax:845-622-3937
Practice Address - Street 1:2225 W INTERSTATE 20
Practice Address - Street 2:SUITE A
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75052-3926
Practice Address - Country:US
Practice Address - Phone:972-602-3937
Practice Address - Fax:845-622-3937
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6202152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXV05398Medicare UPIN
TX8F0405Medicare ID - Type Unspecified