Provider Demographics
NPI:1215128491
Name:CHEN, GEORGE GOVERN (MD)
Entity type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:GOVERN
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 1:2002 HOLCOMBE BLVD
Mailing Address - Street 2:MAIL CODE: 190
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030
Mailing Address - Country:US
Mailing Address - Phone:713-794-7190
Mailing Address - Fax:713-794-7825
Practice Address - Street 1:2002 HOLCOMBE BLVD
Practice Address - Street 2:MAIL CODE: 190
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030
Practice Address - Country:US
Practice Address - Phone:713-794-7190
Practice Address - Fax:713-794-7825
Is Sole Proprietor?:No
Enumeration Date:2007-08-05
Last Update Date:2013-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010923672085R0001X
TXP40352085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
4651659565OtherMYUTMB 4651659565