1861495129 NPI number — DR. C. ALLEN CHU MD,PHD

Table of content: DR. C. ALLEN CHU MD,PHD (NPI 1861495129)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861495129 NPI number — DR. C. ALLEN CHU MD,PHD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHU
Provider First Name:
C.
Provider Middle Name:
ALLEN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD,PHD
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:
1861495129
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/13/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
13215 DOTSON RD STE 320
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:
77070-4535
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-469-8600
Provider Business Mailing Address Fax Number:
281-469-8611

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
13215 DOTSON RD STE 320
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:
77070-4535
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-469-8600
Provider Business Practice Location Address Fax Number:
281-469-8611
Provider Enumeration Date:
05/31/2005

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: 174400000X , with the licence number:  K7002 , 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: 0500246 . This is a "UNITEDHEALTHCAREPROVIDER#" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 2120632 . This is a "AETNA PROVIDER #" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 8659B0 . This is a "BCBS INDIVIDUAL #" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 2086736 . This is a "FIRST HEALTH PROVIDER #" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 6858495 . This is a "CIGNA PROVIDER #" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 150794901 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 181939900 . This is a "WORKERSCOMPPROVIDER#" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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