Chen, Tina

Chen, Tina is an individual health care provider with primary practice located at 1201 Summit Ave , Fort Worth TX 76102-4413. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Ophthalmology, Student, Health Care / Student in an Organized Health Care Education/Training Program. Allopathic & Osteopathic Physicians / Ophthalmology is her primary health care specialty. Chen, Tina can be contacted via phone (817) 332-2020.

Contact Information

Primary practice address
1201 Summit Ave Fort Worth TX 76102-4413
Phone: (817) 332-2020
Fax: (817) 332-4797
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 036.145557 Illinois
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 125065018 Illinois
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X R9737 Texas

Profile Details

NPI number 1679991053
LBN Legal business name Chen, Tina
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 2nd, 2014
Last updated Nov 22nd, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679991053 NPPES
Texas MEDICAID 401702201

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