MEDICARE: LU LIU PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AS0400X	Surgical Physician Assistant	PA02204	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093776635
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LU LIU PA

Provider Business Mailing Address
First Line	:	2821 E PRESIDENT GEORGE BUSH HWY STE 201
Second Line	:
City	:	RICHARDSON
State	:	TX
Zip	:	75082-4277
Country	:	US
Telephone Number	:	972-498-4791
Fax Number	:	972-498-4939

Provider Business Practice Location Address
First Line	:	2821 E PRESIDENT GEORGE BUSH HWY STE 201
Second Line	:
City	:	RICHARDSON
State	:	TX
Zip	:	75082-4277
Country	:	US
Telephone Number	:	972-498-4791
Fax Number	:	972-498-4939

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/31/2006
Last Update Date	:	08/13/2024

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1164429395 — MR. JOHN TSU-YUAN WEY M.D.
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1336147867 — DR. DIANE SUE LITKE M.D.
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RICHARDSON, TX
75082-4277

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Practice Location Address:

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1225080609 — CHRISTINE MCRAE PA-C
Practice Location Address:

2821 E PRESIDENT GEORGE BUSH HWY STE 300
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1629006432 — THOMAS CHRISTOPHER FRANK M.D.
Practice Location Address:

2821 E PRESIDENT GEORGE BUSH HWY , SUITE 210
RICHARDSON, TX
75082-4277

Practice Phone: 972-231-9361
Practice Fax: 972-231-3123

Directions to “ LU LIU PA” Practice Location

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