Provider Demographics
NPI:1376009837
Name:CHUA, CATHERINE (LAT ATC)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:CHUA
Suffix:
Gender:F
Credentials:LAT ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9200 WORLD CUP WAY STE 202
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75033-4958
Mailing Address - Country:US
Mailing Address - Phone:520-820-0698
Mailing Address - Fax:
Practice Address - Street 1:9200 WORLD CUP WAY STE 202
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-4958
Practice Address - Country:US
Practice Address - Phone:520-820-0698
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-20
Last Update Date:2022-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
2000036485OtherBOC
TXAT8092OtherTEXAS LICENSE OF ATHLETIC TRAINING