Provider Demographics
NPI:1750355418
Name:CHIN, KAREN DE LEON (MD)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:DE LEON
Last Name:CHIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:
Other - Last Name:DE LEON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3502 PINNACLE DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78261-2352
Mailing Address - Country:US
Mailing Address - Phone:210-521-5703
Mailing Address - Fax:
Practice Address - Street 1:2015 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78215-1117
Practice Address - Country:US
Practice Address - Phone:210-961-4118
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-16
Last Update Date:2020-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM2286207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8M8138OtherBCBS
TX177316002Medicaid
TX177316001Medicaid
TX177316001Medicaid
TX8M8138OtherBCBS
TXP00251340Medicare PIN
TX611976Medicare PIN