Provider Demographics
NPI:1376742569
Name:CHAU, LIEU NGOC (DO)
Entity Type:Individual
Prefix:
First Name:LIEU
Middle Name:NGOC
Last Name:CHAU
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8901 BOONE RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77099-1659
Mailing Address - Country:US
Mailing Address - Phone:281-454-0519
Mailing Address - Fax:281-454-0943
Practice Address - Street 1:8901 BOONE RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77099-1659
Practice Address - Country:US
Practice Address - Phone:281-454-0519
Practice Address - Fax:281-454-0943
Is Sole Proprietor?:No
Enumeration Date:2007-07-17
Last Update Date:2016-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN2027207Q00000X
TXBP1-0029848390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX280530101Medicaid