Healthcare Provider Details

I. General information

NPI: 1194986760
Provider Name (Legal Business Name): HAO WU M.D., PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2008
Last Update Date: 06/23/2021
Certification Date: 06/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6621 FANNIN ST WB1100
HOUSTON TX
77030-2358
US

IV. Provider business mailing address

6621 FANNIN ST WB1100
HOUSTON TX
77030-2358
US

V. Phone/Fax

Practice location:
  • Phone: 832-824-6422
  • Fax: 832-825-0164
Mailing address:
  • Phone: 832-824-6422
  • Fax: 832-825-0164

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number67538
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: