Provider Demographics
NPI:1316090392
Name:CHU, KIM-THU T (MD)
Entity type:Individual
Prefix:MRS
First Name:KIM-THU
Middle Name:T
Last Name:CHU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12606 W HOUSTON CENTER BLVD STE 302
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-2788
Mailing Address - Country:US
Mailing Address - Phone:713-230-8677
Mailing Address - Fax:281-345-7587
Practice Address - Street 1:12606 W HOUSTON CENTER BLVD STE 302
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-2788
Practice Address - Country:US
Practice Address - Phone:713-230-8677
Practice Address - Fax:281-345-7587
Is Sole Proprietor?:No
Enumeration Date:2007-01-21
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK5271207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0925059Medicaid
TX092505901Medicaid
TXZ0110045OtherDEPT OF PUBLIC SAFETY
TXZ0110045OtherDEPT OF PUBLIC SAFETY
TXZ0110045OtherDEPT OF PUBLIC SAFETY
H12819Medicare UPIN
TX00457LMedicare ID - Type UnspecifiedMEDICARE
TXBC6174964OtherDEA NUMBER