1760426308 NPI number — DR. SCOTT Y WU M.D.

Table of content: DR. SCOTT Y WU M.D. (NPI 1760426308)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1760426308 NPI number — DR. SCOTT Y WU M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WU
Provider First Name:
SCOTT
Provider Middle Name:
Y
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1760426308
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/06/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6431 FANNIN ST STE MSB 4234
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77030-1501
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-500-6683
Provider Business Mailing Address Fax Number:
713-500-6699

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5656 KELLEY ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77026-1967
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-500-6683
Provider Business Practice Location Address Fax Number:
713-500-6699
Provider Enumeration Date:
06/15/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RG0100X , with the licence number:  036086196 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RG0100X , with the licence number: W1717 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 026249 . This is a "HEALTH ALLIANCE" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 371221637 . This is a "FEDERAL TAX IDENTIFICATIO" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 5134066 . This is a "AETNA HEALTH PLANS" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 776530 . This is a "MEDICARE GROUP NUMBER" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 036086196 , issued by the state of ( IL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 07215152 . This is a "BLUE CROSS" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: IL0109 . This is a "JOHN DEERE" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 295120 . This is a "HEALTHLINK" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".




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