Provider Demographics
NPI:1891995411
Name:CHEN, CHRISTINA ANN (M D)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:ANN
Last Name:CHEN
Suffix:
Gender:F
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1000 W STATE HIGHWAY 6 STE 120
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76712-3787
Mailing Address - Country:US
Mailing Address - Phone:254-306-0347
Mailing Address - Fax:254-488-3284
Practice Address - Street 1:1000 W STATE HIGHWAY 6 STE 120
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76712-3787
Practice Address - Country:US
Practice Address - Phone:254-306-0347
Practice Address - Fax:254-488-3284
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-22
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM15792084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry