Provider Demographics
NPI:1063971257
Name:CU, JONATHAN THANG (BSN-RN)
Entity type:Individual
Prefix:MR
First Name:JONATHAN
Middle Name:THANG
Last Name:CU
Suffix:
Gender:M
Credentials:BSN-RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5961 W PARKER RD APT 1156
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-7721
Mailing Address - Country:US
Mailing Address - Phone:228-313-8767
Mailing Address - Fax:
Practice Address - Street 1:5961 W PARKER RD APT 1156
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-7721
Practice Address - Country:US
Practice Address - Phone:228-313-8767
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-18
Last Update Date:2019-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX959491163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse