Provider Demographics
NPI:1598103996
Name:CHEN, PETER PO TAO (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:PO TAO
Last Name:CHEN
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3007 WOODLAND HILLS DRIVE, #94
Mailing Address - Street 2:
Mailing Address - City:KINGSWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-1403
Mailing Address - Country:US
Mailing Address - Phone:832-412-8670
Mailing Address - Fax:832-559-0652
Practice Address - Street 1:3007 WOODLAND HILLS DR # 94
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-1403
Practice Address - Country:US
Practice Address - Phone:832-412-8670
Practice Address - Fax:832-559-0562
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-06
Last Update Date:2020-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS7023207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology