Provider Demographics
NPI:1720204522
Name:EDWARD KUO, M.D., P.A.
Entity Type:Organization
Organization Name:EDWARD KUO, M.D., P.A.
Other - Org Name:WASHINGTON AVENUE FAMILY PRACTICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:L
Authorized Official - Last Name:KUO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-861-5505
Mailing Address - Street 1:PO BOX 131165
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77219-1165
Mailing Address - Country:US
Mailing Address - Phone:713-851-5505
Mailing Address - Fax:713-861-5515
Practice Address - Street 1:4602 WASHINGTON AVE
Practice Address - Street 2:SUITE B
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77007-5434
Practice Address - Country:US
Practice Address - Phone:713-861-5505
Practice Address - Fax:713-861-5515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2008-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG98264Medicare UPIN
TX00299WMedicare PIN