Healthcare Provider Details

I. General information

NPI: 1538519145
Provider Name (Legal Business Name): ZHONGCHUN ZHU M.D. ORIENTAL MED.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/14/2016
Last Update Date: 04/17/2020
Certification Date: 04/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3131 CUSTER RD STE 255
PLANO TX
75075-4426
US

IV. Provider business mailing address

2400 RESTON DR
MCKINNEY TX
75072-8840
US

V. Phone/Fax

Practice location:
  • Phone: 972-599-1268
  • Fax: 972-599-1268
Mailing address:
  • Phone: 972-984-9386
  • Fax: 972-599-1268

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC01243
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMT118328
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: