Provider Demographics
NPI:1447483490
Name:CHEN, YING-CHOU (OD)
Entity type:Individual
Prefix:DR
First Name:YING-CHOU
Middle Name:
Last Name:CHEN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:DR
Other - First Name:JIMMY
Other - Middle Name:
Other - Last Name:CHEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:13301 GATEWAY CENTER DR
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20155-2984
Mailing Address - Country:US
Mailing Address - Phone:305-898-7124
Mailing Address - Fax:571-261-5017
Practice Address - Street 1:13301 GATEWAY CENTER DR
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:VA
Practice Address - Zip Code:20155-2984
Practice Address - Country:US
Practice Address - Phone:703-754-3179
Practice Address - Fax:571-261-5017
Is Sole Proprietor?:No
Enumeration Date:2009-08-25
Last Update Date:2013-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618001877152W00000X
FLOPC 4431152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist