Provider Demographics
NPI:1407148604
Name:CHEN, JASON (DO, MS)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:CHEN
Suffix:
Gender:M
Credentials:DO, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5420 WEST LOOP S STE 1100
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-2115
Mailing Address - Country:US
Mailing Address - Phone:713-486-5590
Mailing Address - Fax:713-486-0879
Practice Address - Street 1:5420 WEST LOOP S STE 1100
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-2115
Practice Address - Country:US
Practice Address - Phone:713-486-5590
Practice Address - Fax:713-486-0879
Is Sole Proprietor?:No
Enumeration Date:2011-05-05
Last Update Date:2018-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ88552081P2900X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX366830301Medicaid
TX8GB063OtherBCBS
TX553369YKY3Medicare Oscar/Certification