Provider Demographics
NPI:1750319752
Name:HSU, KENNETH S (MD)
Entity Type:Individual
Prefix:
First Name:KENNETH
Middle Name:S
Last Name:HSU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:KENNETH
Other - Middle Name:S
Other - Last Name:HSU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:5220 W. UNIVERSITY DRIVE SUITE 150
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071
Mailing Address - Country:US
Mailing Address - Phone:972-984-1050
Mailing Address - Fax:972-984-1376
Practice Address - Street 1:4001 W. 15TH STREET
Practice Address - Street 2:SUITE 225
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093
Practice Address - Country:US
Practice Address - Phone:972-984-1050
Practice Address - Fax:972-984-1376
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-29
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM2353207Y00000X
TXM2553207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXI49278Medicare UPIN
8F2200Medicare ID - Type Unspecified