Provider Demographics
NPI:1013942705
Name:CHEN, YEE-RU (DO)
Entity type:Individual
Prefix:
First Name:YEE-RU
Middle Name:
Last Name:CHEN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11511 SHADOW CREEK PKWY
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-7298
Mailing Address - Country:US
Mailing Address - Phone:713-442-0000
Mailing Address - Fax:
Practice Address - Street 1:1200 MCKINNEY ST
Practice Address - Street 2:SUITE 473
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77010
Practice Address - Country:US
Practice Address - Phone:713-442-4700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2021-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL6825207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX171567402Medicaid
TX171567404Medicaid
TX171567401Medicaid
TX171567401Medicaid
TX8D3655Medicare PIN
TX171567401Medicaid