Provider Demographics
NPI:1588052526
Name:LU, JENNIFER (PA-C)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:
Last Name:LU
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16605 S.W. FREEWAY, SUITE 320
Mailing Address - Street 2:METHODIST SUGAR LAND HOSPITAL, MEDICAL OFFICE BLDG 3
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479
Mailing Address - Country:US
Mailing Address - Phone:281-265-0225
Mailing Address - Fax:
Practice Address - Street 1:16605 S.W. FREEWAY, SUITE 320
Practice Address - Street 2:METHODIST SUGAR LAND HOSPITAL, MEDICAL OFFICE BLDG 3
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479
Practice Address - Country:US
Practice Address - Phone:281-870-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-29
Last Update Date:2015-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA08893363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant