Provider Demographics
NPI:1477583763
Name:CHEN, JUN (MD)
Entity Type:Individual
Prefix:
First Name:JUN
Middle Name:
Last Name:CHEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3315 COLORADO BLVD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76210-6884
Mailing Address - Country:US
Mailing Address - Phone:940-320-1708
Mailing Address - Fax:940-565-5457
Practice Address - Street 1:4240 INTERNATIONAL PKWY
Practice Address - Street 2:STE. 154
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75007
Practice Address - Country:US
Practice Address - Phone:469-574-0464
Practice Address - Fax:469-574-0471
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2015-12-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXM2283207RN0300X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX177883902Medicaid
TX177883902Medicaid
TX177883901Medicaid
TX8D8937Medicare ID - Type Unspecified
8K7982Medicare PIN