Healthcare Provider Details

I. General information

NPI: 1851620991
Provider Name (Legal Business Name): CENTRAL TEXAS HOSPITAL PHYSICIANS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2009
Last Update Date: 11/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4424 GAINES RANCH LOOP STE 1515
AUSTIN TX
78735-6492
US

IV. Provider business mailing address

PO BOX 41138
AUSTIN TX
78704-0019
US

V. Phone/Fax

Practice location:
  • Phone: 512-796-3893
  • Fax:
Mailing address:
  • Phone: 512-796-3893
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberL9023
License Number StateTX

VIII. Authorized Official

Name: DR. ANDY CHIN HUNG WU
Title or Position: OWNER
Credential: M.D.
Phone: 512-796-3893