Provider Demographics
NPI:1457887481
Name:CHEN, VICTORIA I (DO)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:I
Last Name:CHEN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 HARMON AVE APT 245
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-2357
Mailing Address - Country:US
Mailing Address - Phone:469-682-6523
Mailing Address - Fax:
Practice Address - Street 1:4515 SETON CENTER PKWY STE 220
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-5784
Practice Address - Country:US
Practice Address - Phone:512-338-8388
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-11
Last Update Date:2020-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOT017907390200000X
TXS5863207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program