Provider Demographics
NPI:1457616492
Name:ZHU, XIAOXU (DDS)
Entity Type:Individual
Prefix:
First Name:XIAOXU
Middle Name:
Last Name:ZHU
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5608 BEDFORD LN
Mailing Address - Street 2:
Mailing Address - City:THE COLONY
Mailing Address - State:TX
Mailing Address - Zip Code:75056-3784
Mailing Address - Country:US
Mailing Address - Phone:573-746-0091
Mailing Address - Fax:
Practice Address - Street 1:3620 E ROSEDALE ST
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76105-2449
Practice Address - Country:US
Practice Address - Phone:817-531-3500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-05
Last Update Date:2016-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX280791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice