Provider Demographics
NPI:1790750461
Name:CHEN, CATHERINE MAI-YU (MD)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:MAI-YU
Last Name:CHEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1140 STONE CREEK DR
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75069-0143
Mailing Address - Country:US
Mailing Address - Phone:972-636-8776
Mailing Address - Fax:
Practice Address - Street 1:1105 CENTRAL EXPY N
Practice Address - Street 2:STE 240
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-6104
Practice Address - Country:US
Practice Address - Phone:972-908-2555
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-17
Last Update Date:2017-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01050542A207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200225590AMedicaid
IN200235690Medicaid
E94705Medicare UPIN
IN200225590AMedicaid