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General NPI Number Information
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NPI Number | 1659733715
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Entity Type | Individual
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Provider Name | MR. DEREK STEPHEN LU
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Gender | Male
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Dates
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Enumeration Date | 03/27/2016
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Last Update Date | 03/27/2016
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Provider Practice Location Address
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Address Line | 7200 CAMBRIDGE ST SUITE 9A
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City | HOUSTON
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State | TX
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Zip | 77030-4202
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Country | US
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Telephone | 713-798-4696
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Fax |
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Provider Business Mailing Address
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Address Line | 5550 E EL PARQUE ST
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City | LONG BEACH
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State | CA
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Zip | 90815-4127
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Country | US
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Telephone | 626-450-5666
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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