Healthcare Provider Details

I. General information

NPI: 1942938295
Provider Name (Legal Business Name): CHIA-HSUAN HUANG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2022
Last Update Date: 03/19/2025
Certification Date: 03/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6720 BERTNER AVE STE O-520
HOUSTON TX
77030-2604
US

IV. Provider business mailing address

1201 W UNIVERSITY DR
EDINBURG TX
78539-2909
US

V. Phone/Fax

Practice location:
  • Phone: 832-355-1000
  • Fax:
Mailing address:
  • Phone: 956-665-7049
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number1942938295
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: