Provider Demographics
NPI:1700897246
Name:CHINN, ELENA N (MD)
Entity Type:Individual
Prefix:MRS
First Name:ELENA
Middle Name:N
Last Name:CHINN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2504 RIDGE RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75087-2569
Mailing Address - Country:US
Mailing Address - Phone:972-771-1794
Mailing Address - Fax:972-771-1648
Practice Address - Street 1:2504 RIDGE RD
Practice Address - Street 2:SUITE 102
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75087-2569
Practice Address - Country:US
Practice Address - Phone:972-771-1794
Practice Address - Fax:972-771-1648
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM1586208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics