Provider Demographics
NPI:1235222639
Name:SHUCHART, CHRISTINE LIU (OD)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:LIU
Last Name:SHUCHART
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1519 TIMBER CREEK DR
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-4558
Mailing Address - Country:US
Mailing Address - Phone:281-835-6902
Mailing Address - Fax:
Practice Address - Street 1:13615 BELLAIRE BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77083-1714
Practice Address - Country:US
Practice Address - Phone:281-933-3445
Practice Address - Fax:281-933-6865
Is Sole Proprietor?:No
Enumeration Date:2006-09-30
Last Update Date:2008-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5498TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX5498TGOtherSTATE LICENSE NUMBER
TX4743680001OtherCIGNA GOV SERVICES NUMBER
TX4743680001OtherCIGNA GOV SERVICES NUMBER