Provider Demographics
NPI:1164728044
Name:CHU, RICHARD CHUN-HSIEN (DO)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:CHUN-HSIEN
Last Name:CHU
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4631 S HULEN ST
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76132-1401
Mailing Address - Country:US
Mailing Address - Phone:817-346-7077
Mailing Address - Fax:817-346-6998
Practice Address - Street 1:4631 S HULEN ST
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76132-1401
Practice Address - Country:US
Practice Address - Phone:817-346-7077
Practice Address - Fax:817-346-6998
Is Sole Proprietor?:No
Enumeration Date:2011-02-10
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101017963207W00000X
TXP3302174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB164825Medicare PIN