Provider Demographics
NPI:1972380434
Name:FUNG WU, SHIRLEY (PA-C)
Entity Type:Individual
Prefix:
First Name:SHIRLEY
Middle Name:
Last Name:FUNG WU
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25230 KINGSLAND BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-2097
Mailing Address - Country:US
Mailing Address - Phone:281-746-9284
Mailing Address - Fax:
Practice Address - Street 1:25230 KINGSLAND BLVD STE 101
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-2097
Practice Address - Country:US
Practice Address - Phone:281-746-9284
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-08
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant