MEDICARE: DR. JACK HUA M.D.

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	2082S0099X	Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician	U1289	TX
2	2086S0122X	Plastic and Reconstructive Surgery Physician	U1289	TX

General Provider Information

NPI Number	:	1649657214
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JACK HUA M.D.

Provider Business Mailing Address
First Line	:	24200 VIA MAZZINI WAY
Second Line	:	SUITE 140
City	:	RICHMOND
State	:	TX
Zip	:	77406-1062
Country	:	US
Telephone Number	:	832-930-2678
Fax Number	:	713-565-0391

Provider Business Practice Location Address
First Line	:	24200 VIA MAZZINI WAY STE 140
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77406-3439
Country	:	US
Telephone Number	:	347-788-8737
Fax Number	:

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

Provider Enumeration Date	:	05/02/2015
Last Update Date	:	11/24/2025

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