Provider Demographics
NPI:1891139630
Name:LU, JONATHAN
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:
Last Name:LU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24721 TOMBALL PKWY
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77375-7727
Mailing Address - Country:US
Mailing Address - Phone:281-975-1000
Mailing Address - Fax:
Practice Address - Street 1:24721 TOMBALL PKWY
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77375-7727
Practice Address - Country:US
Practice Address - Phone:281-975-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-23
Last Update Date:2020-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS1170207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology