Provider Demographics
NPI:1407963317
Name:CHEN-HAH, MARIAN M (MD)
Entity Type:Individual
Prefix:
First Name:MARIAN
Middle Name:M
Last Name:CHEN-HAH
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 1:610 STRICKLAND DR
Mailing Address - Street 2:#270
Mailing Address - City:ORANGE
Mailing Address - State:TX
Mailing Address - Zip Code:77630-4786
Mailing Address - Country:US
Mailing Address - Phone:409-883-3580
Mailing Address - Fax:877-991-9248
Practice Address - Street 1:610 STRICKLAND DR
Practice Address - Street 2:#290
Practice Address - City:ORANGE
Practice Address - State:TX
Practice Address - Zip Code:77630-4786
Practice Address - Country:US
Practice Address - Phone:409-883-3580
Practice Address - Fax:877-991-9248
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2016-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ7929207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX84941FOtherBCBS OF TX
TX8BB411OtherBCBS OF TX
TXP089X2042Medicaid
TX1185266-01OtherMEDICAID TPI
TX1185266-02OtherMEDICAID TPI
TX84941FOtherBCBS OF TX
TXP089X2042Medicaid
TX89X203Medicare PIN