Provider Demographics
NPI:1497785109
Name:ALLEN H CHIN OD A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:ALLEN H CHIN OD A PROFESSIONAL CORPORATION
Other - Org Name:DR. ALLEN H. CHIN AND ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:CHIN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:713-774-1124
Mailing Address - Street 1:6910 BELLAIRE BLVD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-3509
Mailing Address - Country:US
Mailing Address - Phone:713-774-1124
Mailing Address - Fax:713-774-4038
Practice Address - Street 1:6910 BELLAIRE BLVD
Practice Address - Street 2:SUITE 3
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-3509
Practice Address - Country:US
Practice Address - Phone:713-774-1124
Practice Address - Fax:713-774-4038
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2014-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2319TG152W00000X
TX6391TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00W645Medicare UPIN