Provider Demographics
NPI:1639140460
Name:HSU, CHUNG-SEN (MD)
Entity Type:Individual
Prefix:
First Name:CHUNG-SEN
Middle Name:
Last Name:HSU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:375 MUNICIPAL DRIVE
Mailing Address - Street 2:SUITE 122
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-3543
Mailing Address - Country:US
Mailing Address - Phone:972-234-5375
Mailing Address - Fax:972-437-4621
Practice Address - Street 1:375 MUNICIPAL DRIVE
Practice Address - Street 2:SUITE 122
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-3543
Practice Address - Country:US
Practice Address - Phone:972-234-5375
Practice Address - Fax:972-437-4621
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-30
Last Update Date:2009-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE0246207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX097326502Medicaid
TX00AA29Medicare PIN
TX00N115Medicare PIN
TX097326502Medicaid
C17143Medicare UPIN