Provider Demographics
NPI:1508411505
Name:CHEN, JOHN ARTHUR (PA-C)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:ARTHUR
Last Name:CHEN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3773 BURGE CIR
Mailing Address - Street 2:
Mailing Address - City:FORT SAM HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:78234-1537
Mailing Address - Country:US
Mailing Address - Phone:915-539-9336
Mailing Address - Fax:
Practice Address - Street 1:CRDAMC
Practice Address - Street 2:590 MEDICAL CENTER ROAD
Practice Address - City:FORT CAVAZOS
Practice Address - State:TX
Practice Address - Zip Code:76544
Practice Address - Country:US
Practice Address - Phone:254-288-0044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-06
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1164986363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant