Healthcare Provider Details

I. General information

NPI: 1205219193
Provider Name (Legal Business Name): EVELYN XIAO ZHU AA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: XIAO ZHU AA-C

II. Dates (important events)

Enumeration Date: 07/09/2015
Last Update Date: 08/22/2025
Certification Date: 08/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

504 MEDICAL CENTER BLVD
CONROE TX
77304
US

IV. Provider business mailing address

808 RUSSELL PALMER RD SUITE 151
KINGWOOD TX
77339
US

V. Phone/Fax

Practice location:
  • Phone: 936-539-1111
  • Fax:
Mailing address:
  • Phone: 281-540-7500
  • Fax: 281-540-7502

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367H00000X
TaxonomyAnesthesiologist Assistant
License Number2006
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: