MEDICARE: CARLUS JIA-HWA HU

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	1223G0001X	General Practice Dentistry	28279	TX

General Provider Information

NPI Number	:	1447506530
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLUS JIA-HWA HU

Provider Business Mailing Address
First Line	:	1700 CEDAR SPRINGS RD
Second Line	:	#1511
City	:	DALLAS
State	:	TX
Zip	:	75202-1203
Country	:	US
Telephone Number	:	562-569-3327
Fax Number	:

Provider Business Practice Location Address
First Line	:	1700 CEDAR SPRINGS RD
Second Line	:	#1511
City	:	DALLAS
State	:	TX
Zip	:	75202-1203
Country	:	US
Telephone Number	:	562-569-3327
Fax Number	:

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

Provider Enumeration Date	:	07/26/2012
Last Update Date	:	03/05/2013

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Directions to “ CARLUS JIA-HWA HU ” Practice Location

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