=====================================================
General NPI Number Information
=====================================================
NPI Number | 1083678882
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ALEXANDER TIU, MD, PA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/17/2006
-----------------------------------------------------
Last Update Date | 01/10/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 19411 MCKAY DR STE 250
-----------------------------------------------------
City | HUMBLE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77338-5713
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 832-777-6921
-----------------------------------------------------
Fax | 281-359-6847
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 19411 MCKAY DR STE 250
-----------------------------------------------------
City | HUMBLE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77338-5713
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 832-777-6921
-----------------------------------------------------
Fax | 281-359-6847
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. ALEXANDER TIU
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 281-359-5010
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number | J0412
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------