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General NPI Number Information
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NPI Number | 1568603850
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Entity Type | Organization
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Legal Business Name | JIMMY K. LU, M.D.& ASSOCIATES
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Dates
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Enumeration Date | 03/16/2009
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Last Update Date | 09/22/2010
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Provider Practice Location Address
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Address Line | 3430 W WHEATLAND RD SUITE 119
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City | DALLAS
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State | TX
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Zip | 75237-3446
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Country | US
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Telephone | 972-296-5252
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Fax | 972-283-6790
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Provider Business Mailing Address
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Address Line | 3430 W WHEATLAND RD SUITE 119
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City | DALLAS
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State | TX
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Zip | 75237-3446
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Country | US
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Telephone | 972-296-5252
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Fax | 972-283-6790
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | JIMMY KIEN-TEH LU
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Credential | M.D.
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Telephone | 972-296-5252
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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