Provider Demographics
NPI:1477732394
Name:SHI-TZE LU, M.D., P.A.
Entity Type:Organization
Organization Name:SHI-TZE LU, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHI-TZE
Authorized Official - Middle Name:
Authorized Official - Last Name:LU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-799-1228
Mailing Address - Street 1:4009 BELLAIRE BLVD
Mailing Address - Street 2:SUITE GG
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77025-1168
Mailing Address - Country:US
Mailing Address - Phone:713-799-1228
Mailing Address - Fax:713-799-1229
Practice Address - Street 1:4009 BELLAIRE BLVD
Practice Address - Street 2:SUITE GG
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77025-1168
Practice Address - Country:US
Practice Address - Phone:713-799-1228
Practice Address - Fax:713-799-1229
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-27
Last Update Date:2009-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK3610207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
00970VMedicare PIN
G54701Medicare UPIN