Provider Demographics
NPI:1215122155
Name:CHEN, JING LIN (WHCNP)
Entity type:Individual
Prefix:
First Name:JING
Middle Name:LIN
Last Name:CHEN
Suffix:
Gender:F
Credentials:WHCNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 660599
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75266-0599
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1400 N WESTMORELAND RD
Practice Address - Street 2:DEHARO SALDIVAR WOMEN'S HEALTH CENTER
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75211-1656
Practice Address - Country:US
Practice Address - Phone:214-266-0580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-13
Last Update Date:2009-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX702928363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX197403206Medicaid
TX197403204Medicaid
TX197403209Medicaid
TX197403202Medicaid
TX197403205Medicaid
TX197403201Medicaid
TX197403203Medicaid
TX8Y2769OtherBLUE CROSS BLUE SHIELD
TX197403207Medicaid
TX197403208Medicaid
TX197403210Medicaid