Provider Demographics
NPI:1124131412
Name:CHEN, RICHARD C (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:C
Last Name:CHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4716 ALLIANCE BLVD STE 500
Mailing Address - Street 2:BAYLOR MEDICAL PLAZA 1
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-5339
Mailing Address - Country:US
Mailing Address - Phone:469-800-6000
Mailing Address - Fax:469-800-6052
Practice Address - Street 1:4716 ALLIANCE BLVD STE 500
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5386
Practice Address - Country:US
Practice Address - Phone:469-800-6000
Practice Address - Fax:469-800-6052
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK4306207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0454647-02Medicaid
TXP00183942OtherRR MEDICARE
TX110189740OtherRR MEDICARE
TX0454647-01Medicaid
TXG86509Medicare UPIN
TX0454647-02Medicaid
TX87209KMedicare PIN