Provider Demographics
NPI:1114050929
Name:HSU, TERESA I-HUA (OD)
Entity type:Individual
Prefix:DR
First Name:TERESA
Middle Name:I-HUA
Last Name:HSU
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1817 HUNTINGTON CHASE
Mailing Address - Street 2:
Mailing Address - City:CHAMBLEE
Mailing Address - State:GA
Mailing Address - Zip Code:30341-1787
Mailing Address - Country:US
Mailing Address - Phone:678-793-3021
Mailing Address - Fax:
Practice Address - Street 1:500 BROOKHAVEN AVE NE
Practice Address - Street 2:
Practice Address - City:BROOKHAVEN
Practice Address - State:GA
Practice Address - Zip Code:30319-3291
Practice Address - Country:US
Practice Address - Phone:404-460-1928
Practice Address - Fax:404-460-1929
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2024-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA002240152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA002240OtherGEORGIA LICENSE NUMBER
GA002240OtherGEORGIA LICENSE NUMBER