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General NPI Number Information
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NPI Number | 1740544766
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Entity Type | Individual
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Provider Name | JOSE ANDRES WU DENTIST
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Gender | Male
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Dates
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Enumeration Date | 06/25/2012
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Last Update Date | 03/18/2021
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Provider Practice Location Address
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Address Line | 4407 WEST FUQUA STREET #R
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City | HOUSTON
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State | TX
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Zip | 77045
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Country | US
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Telephone | 713-434-7333
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Fax | 713-434-7336
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Provider Business Mailing Address
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Address Line | 5218 BIRCH FALLS LN
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City | SUGAR LAND
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State | TX
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Zip | 77479
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Country | US
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Telephone | 909-556-9805
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 61379
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 28172
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License Number State | TX
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