Provider Demographics
NPI:1568679306
Name:CHAU, HUNG TRI (DDS)
Entity Type:Individual
Prefix:
First Name:HUNG
Middle Name:TRI
Last Name:CHAU
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3444 ELLA BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77018-6100
Mailing Address - Country:US
Mailing Address - Phone:713-681-0140
Mailing Address - Fax:713-681-0127
Practice Address - Street 1:3444 ELLA BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77018-6100
Practice Address - Country:US
Practice Address - Phone:713-681-0140
Practice Address - Fax:713-681-0127
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17538122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN111114820Medicaid