MEDICARE: DR. CHAU DOAN KHUU M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207LP2900X	Pain Medicine (Anesthesiology) Physician	237238	NY
2	174400000X	Specialist	M4838	TX

General Provider Information

NPI Number	:	1306868245
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHAU DOAN KHUU M.D.

Provider Business Mailing Address
First Line	:	12335 JAGUAR DR
Second Line	:
City	:	STAFFORD
State	:	TX
Zip	:	77477-1254
Country	:	US
Telephone Number	:	718-795-8703
Fax Number	:

Provider Business Practice Location Address
First Line	:	214 AVENUE S
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11223-2629
Country	:	US
Telephone Number	:	718-759-6207
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/23/2006
Last Update Date	:	12/10/2012

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