Provider Demographics
NPI:1124157813
Name:MU, PU (LAC)
Entity type:Individual
Prefix:
First Name:PU
Middle Name:
Last Name:MU
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13217 BELLAIRE BLVD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77083-2635
Mailing Address - Country:US
Mailing Address - Phone:281-988-8500
Mailing Address - Fax:281-988-8500
Practice Address - Street 1:13217 BELLAIRE BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77083-2635
Practice Address - Country:US
Practice Address - Phone:281-988-8500
Practice Address - Fax:281-988-8500
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC00304171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist