Provider Demographics
NPI:1720071350
Name:HSU, MICHAEL KUANG (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:KUANG
Last Name:HSU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6133 PARKWAY
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78414-2459
Mailing Address - Country:US
Mailing Address - Phone:409-886-1489
Mailing Address - Fax:409-886-5489
Practice Address - Street 1:6133 PARKWAY
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78414-2459
Practice Address - Country:US
Practice Address - Phone:409-886-1489
Practice Address - Fax:409-886-5489
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-30
Last Update Date:2014-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH0469208600000X
LA07287R208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX098911301Medicaid
TX00J45MMedicare ID - Type Unspecified
TX098911301Medicaid