Provider Demographics
NPI:1891995221
Name:CHEN, ALICE JANE (MD, PHD)
Entity Type:Individual
Prefix:
First Name:ALICE
Middle Name:JANE
Last Name:CHEN
Suffix:
Gender:F
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 1:1 BAYLOR PLZ STE 286A
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-3411
Mailing Address - Country:US
Mailing Address - Phone:713-798-4661
Mailing Address - Fax:179-798-5838
Practice Address - Street 1:1 BAYLOR PLZ STE 286A
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-3411
Practice Address - Country:US
Practice Address - Phone:713-798-4661
Practice Address - Fax:179-798-5838
Is Sole Proprietor?:No
Enumeration Date:2007-07-24
Last Update Date:2008-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM5667207ZB0001X, 207ZP0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory Medicine
No207ZB0001XAllopathic & Osteopathic PhysiciansPathologyBlood Banking & Transfusion Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX189922101Medicaid
TX189922102OtherCSHCN
TX8K5742Medicare PIN
TX189922101Medicaid