Provider Demographics
NPI:1396803474
Name:CHEN, SAMUEL (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:
Last Name:CHEN
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:DR
Other - First Name:CHENG SAMUEL
Other - Middle Name:
Other - Last Name:CHEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD, PHD
Mailing Address - Street 1:PO BOX 981095
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77098-8095
Mailing Address - Country:US
Mailing Address - Phone:713-988-8860
Mailing Address - Fax:713-988-8861
Practice Address - Street 1:9180 BELLAIRE BLVD
Practice Address - Street 2:SUITE E
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-4697
Practice Address - Country:US
Practice Address - Phone:713-988-8860
Practice Address - Fax:713-988-8861
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2024-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK3125207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX127043106Medicaid
TX8839B0Medicare PIN
TXG39553Medicare UPIN