Healthcare Provider Details

I. General information

NPI: 1730162215
Provider Name (Legal Business Name): CHARLES HSU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2005
Last Update Date: 01/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4610 SWEETWATER BLVD SUITE 220
SUGAR LAND TX
77479-3152
US

IV. Provider business mailing address

36 GRANTS LAKE CIR
SUGAR LAND TX
77479-1382
US

V. Phone/Fax

Practice location:
  • Phone: 281-242-1127
  • Fax: 281-242-7478
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberL2325
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: