=====================================================
General NPI Number Information
=====================================================
NPI Number | 1013368166
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | STEVE HU
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/29/2016
-----------------------------------------------------
Last Update Date | 11/12/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 130 S HUMMELL ST
-----------------------------------------------------
City | DENHAM SPRINGS
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70726-3437
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 225-665-2417
-----------------------------------------------------
Fax | 225-665-3724
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 130 S HUMMELL ST
-----------------------------------------------------
City | DENHAM SPRINGS
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70726-3437
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 225-665-2417
-----------------------------------------------------
Fax | 225-665-3724
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223G0001X
-----------------------------------------------------
Taxonomy Name | General Practice Dentistry
-----------------------------------------------------
License Number | 6689
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 1223G0001X
-----------------------------------------------------
Taxonomy Name | General Practice Dentistry
-----------------------------------------------------
License Number | 35733
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------