Provider Demographics
NPI:1437924040
Name:CHEN, GRACE T (OD)
Entity Type:Individual
Prefix:
First Name:GRACE
Middle Name:T
Last Name:CHEN
Suffix:
Gender:F
Credentials:OD
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Mailing Address - Street 1:8614 WESTWOOD CENTER DR FL 9
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-2442
Mailing Address - Country:US
Mailing Address - Phone:703-847-8899
Mailing Address - Fax:571-223-6780
Practice Address - Street 1:2406 HUNTER RD STE 102
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:78666-5256
Practice Address - Country:US
Practice Address - Phone:512-271-6961
Practice Address - Fax:512-754-6197
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-24
Last Update Date:2023-12-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TX10858152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist