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General NPI Number Information
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NPI Number | 1669103404
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Entity Type | Individual
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Provider Name | DAN CHU
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Gender | Male
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Dates
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Enumeration Date | 06/22/2022
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Last Update Date | 01/06/2026
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Provider Practice Location Address
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Address Line | 1217 OAKLAND BLVD
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City | FORT WORTH
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State | TX
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Zip | 76103-1125
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Country | US
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Telephone | 817-457-3853
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Fax | 817-457-2794
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Provider Business Mailing Address
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Address Line | 1911 BRIARCREST LN
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City | ARLINGTON
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State | TX
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Zip | 76012-5703
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Country | US
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Telephone | 817-705-0627
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | BP10080722
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | W0148
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License Number State | TX
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