Provider Demographics
NPI:1518255538
Name:CHU, NICK (OD)
Entity Type:Individual
Prefix:DR
First Name:NICK
Middle Name:
Last Name:CHU
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2071 CYPRESS CREEK RD
Mailing Address - Street 2:UNIT 12
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-3622
Mailing Address - Country:US
Mailing Address - Phone:832-859-8460
Mailing Address - Fax:
Practice Address - Street 1:2071 CYPRESS CREEK RD
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-3622
Practice Address - Country:US
Practice Address - Phone:512-250-1700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-11
Last Update Date:2017-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7725T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist