Provider Demographics
NPI:1336621408
Name:CHEN, ALBERT (OD, MPH)
Entity Type:Individual
Prefix:
First Name:ALBERT
Middle Name:
Last Name:CHEN
Suffix:
Gender:M
Credentials:OD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1708 CHESTER DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75025-2659
Mailing Address - Country:US
Mailing Address - Phone:469-888-1170
Mailing Address - Fax:
Practice Address - Street 1:121 BRIAN ALLGOOD HOSPITAL
Practice Address - Street 2:UNIT 15281
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:96205
Practice Address - Country:US
Practice Address - Phone:315-737-4801
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-05
Last Update Date:2018-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3475152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist