Provider Demographics
NPI:1710952668
Name:CHEN, SHAWN C (MD)
Entity Type:Individual
Prefix:DR
First Name:SHAWN
Middle Name:C
Last Name:CHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3267 BEE CAVES ROAD
Mailing Address - Street 2:SUITE 107 #354
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746
Mailing Address - Country:US
Mailing Address - Phone:512-660-6580
Mailing Address - Fax:512-674-9058
Practice Address - Street 1:3267 BEE CAVES ROAD
Practice Address - Street 2:SUITE 107 #354
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746
Practice Address - Country:US
Practice Address - Phone:512-660-6580
Practice Address - Fax:512-674-9058
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2015-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01060293A207R00000X
TXN1281207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200314580Medicaid
INP00275304Medicare PIN
INI28060Medicare UPIN
TXTXB103502Medicare PIN
IN165460WWWMedicare PIN