Provider Demographics
NPI:1760667315
Name:CHIU, JEANIE (MD)
Entity Type:Individual
Prefix:DR
First Name:JEANIE
Middle Name:
Last Name:CHIU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8501 VENTURA LN
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-7760
Mailing Address - Country:US
Mailing Address - Phone:209-352-8950
Mailing Address - Fax:
Practice Address - Street 1:8501 VENTURA LN
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-7760
Practice Address - Country:US
Practice Address - Phone:209-352-8950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-02
Last Update Date:2016-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN3562207ZB0001X, 207ZP0105X, 207Q00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207ZB0001XAllopathic & Osteopathic PhysiciansPathologyBlood Banking & Transfusion Medicine
No207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine