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General NPI Number Information
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NPI Number | 1790958197
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Entity Type | Organization
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Legal Business Name | CHONG LIU, MD, PA
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Dates
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Enumeration Date | 04/07/2008
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Last Update Date | 04/07/2008
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Provider Practice Location Address
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Address Line | 1120 W CAMPBELL RD SUITE 111
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City | RICHARDSON
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State | TX
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Zip | 75080-2976
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Country | US
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Telephone | 972-669-1212
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Fax | 972-669-1313
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Provider Business Mailing Address
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Address Line | 1120 W CAMPBELL RD SUITE 111
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City | RICHARDSON
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State | TX
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Zip | 75080-2976
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Country | US
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Telephone | 972-669-1212
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Fax | 972-669-1313
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. CHONG H LIU
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Credential | M.D.
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Telephone | 972-669-1212
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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 | K9837
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License Number State | TX
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