Provider Demographics
NPI:1922181916
Name:CHU, ALFRED ALAN SP (MD)
Entity type:Individual
Prefix:
First Name:ALFRED
Middle Name:ALAN SP
Last Name:CHU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 PORT LN
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-2430
Mailing Address - Country:US
Mailing Address - Phone:806-358-4596
Mailing Address - Fax:806-468-0240
Practice Address - Street 1:1901 PORT LN
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-2430
Practice Address - Country:US
Practice Address - Phone:806-358-4596
Practice Address - Fax:806-468-0240
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM5103207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8J3256Medicare PIN
TXE64522Medicare UPIN