Provider Demographics
NPI:1952051708
Name:FUKUI MEDICAL PLLC
Entity Type:Organization
Organization Name:FUKUI MEDICAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:RIYA
Authorized Official - Middle Name:
Authorized Official - Last Name:FUKUI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-363-0913
Mailing Address - Street 1:12645 MEMORIAL DR
Mailing Address - Street 2:STE F1 #511
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024
Mailing Address - Country:US
Mailing Address - Phone:832-377-0208
Mailing Address - Fax:
Practice Address - Street 1:13428 BISSONNET ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77083-6275
Practice Address - Country:US
Practice Address - Phone:713-351-4300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-25
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty