Healthcare Provider Details

I. General information

NPI: 1831198241
Provider Name (Legal Business Name): GLADYS S TSAO-WU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2005
Last Update Date: 06/05/2025
Certification Date: 06/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 ENCINO PL NE D-7
ALBUQUERQUE NM
87102-2612
US

IV. Provider business mailing address

800 BRADBURY DR SE STE 116
ALBUQUERQUE NM
87106-4310
US

V. Phone/Fax

Practice location:
  • Phone: 505-842-6868
  • Fax: 505-842-9325
Mailing address:
  • Phone: 505-272-1476
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberMD 2006-0440
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: