Provider Demographics
NPI:1184652059
Name:CHUA, EVELYN (MD)
Entity Type:Individual
Prefix:
First Name:EVELYN
Middle Name:
Last Name:CHUA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 SWITCHBUD PL STE 316
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-3700
Mailing Address - Country:US
Mailing Address - Phone:281-810-9195
Mailing Address - Fax:281-815-2083
Practice Address - Street 1:7 SWITCHBUD PL STE 316
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-3700
Practice Address - Country:US
Practice Address - Phone:281-810-9195
Practice Address - Fax:281-815-2083
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL3941207R00000X, 207RA0000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RA0000XAllopathic & Osteopathic PhysiciansInternal MedicineAdolescent Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00J21AOtherGROUP MEDICARE NUMBER
TX00J21AOtherGROUP MEDICARE NUMBER
H80024Medicare UPIN