Healthcare Provider Details

I. General information

NPI: 1093169120
Provider Name (Legal Business Name): ALBERT HUH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2016
Last Update Date: 09/23/2021
Certification Date: 09/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5323 HARRY HINES BLVD STOP 7200
DALLAS TX
75390-3411
US

IV. Provider business mailing address

PO BOX 845347
DALLAS TX
75284-5347
US

V. Phone/Fax

Practice location:
  • Phone: 214-648-6400
  • Fax: 214-648-5461
Mailing address:
  • Phone: 469-291-3369
  • Fax: 214-645-0078

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberT1392
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberT1392
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: