Provider Demographics
NPI:1083678882
Name:ALEXANDER TIU, MD, PA
Entity Type:Organization
Organization Name:ALEXANDER TIU, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:TIU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-359-5010
Mailing Address - Street 1:19411 MCKAY DR STE 250
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338-5713
Mailing Address - Country:US
Mailing Address - Phone:832-777-6921
Mailing Address - Fax:281-359-6847
Practice Address - Street 1:19411 MCKAY DR STE 250
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-5713
Practice Address - Country:US
Practice Address - Phone:832-777-6921
Practice Address - Fax:281-359-6847
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-17
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ0412174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX156862801Medicaid
TX00662UMedicare PIN
TX00568YMedicare PIN