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General NPI Number Information
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NPI Number | 1568033496
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Entity Type | Individual
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Provider Name | BRYAN CHII-YEU CHU
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Gender | Male
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Dates
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Enumeration Date | 07/01/2021
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Last Update Date | 09/21/2023
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Provider Practice Location Address
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Address Line | 1505 E RIO GRANDE ST STE 120
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City | VICTORIA
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State | TX
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Zip | 77901-7397
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Country | US
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Telephone | 361-235-4283
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Fax |
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Provider Business Mailing Address
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Address Line | 11209 MATISSE TRL
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City | AUSTIN
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State | TX
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Zip | 78726-1449
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Country | US
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Telephone | 512-264-5927
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 37363
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 37363
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License Number State | TX
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