Provider Demographics
NPI:1902358823
Name:LU, PEI W
Entity Type:Individual
Prefix:
First Name:PEI W
Middle Name:
Last Name:LU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2671 BRAZOS RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-8932
Mailing Address - Country:US
Mailing Address - Phone:832-876-2497
Mailing Address - Fax:
Practice Address - Street 1:2020 NASA PKWY STE 220
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-3697
Practice Address - Country:US
Practice Address - Phone:713-369-1969
Practice Address - Fax:713-369-1969
Is Sole Proprietor?:No
Enumeration Date:2016-10-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP131779363LF0000X
TX815629163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse