Provider Demographics
NPI:1154071546
Name:CHAU, JENNY THANH (PA)
Entity type:Individual
Prefix:
First Name:JENNY
Middle Name:THANH
Last Name:CHAU
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1301 BARBARA JORDAN BLVD STE 302
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-3078
Mailing Address - Country:US
Mailing Address - Phone:512-472-6134
Mailing Address - Fax:512-472-4601
Practice Address - Street 1:1301 BARBARA JORDAN BLVD STE 302
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78723-3078
Practice Address - Country:US
Practice Address - Phone:512-472-6134
Practice Address - Fax:512-472-4601
Is Sole Proprietor?:No
Enumeration Date:2022-03-28
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4814363A00000X
TXPA17090363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant