Provider Demographics
NPI:1346342714
Name:LU, JOHN MING-SHIEH (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:MING-SHIEH
Last Name:LU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 PRESTON ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469-1419
Mailing Address - Country:US
Mailing Address - Phone:281-232-2075
Mailing Address - Fax:281-344-4606
Practice Address - Street 1:2100 PRESTON ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77469-1419
Practice Address - Country:US
Practice Address - Phone:281-232-2075
Practice Address - Fax:281-344-4606
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-05
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ7813207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX043784001Medicaid
TXTXB101484Medicare PIN
TX043784001Medicaid
TXTXB101484Medicare PIN