Provider Demographics
NPI:1649365545
Name:LIU, CHONG HUI (MD)
Entity type:Individual
Prefix:
First Name:CHONG
Middle Name:HUI
Last Name:LIU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1120 W CAMPBELL RD
Mailing Address - Street 2:SUITE NUMBER 111
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-2976
Mailing Address - Country:US
Mailing Address - Phone:972-669-1212
Mailing Address - Fax:972-669-1313
Practice Address - Street 1:1120 W CAMPBELL RD
Practice Address - Street 2:SUITE NUMBER 111
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-2976
Practice Address - Country:US
Practice Address - Phone:972-669-1212
Practice Address - Fax:972-669-1313
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK9837207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXK9837OtherTEXAS LICENSE NUMBER
TXK9837OtherTEXAS LICENSE NUMBER
TX00699QMedicare ID - Type UnspecifiedMEDICARE NUMBER
TXBL6443030OtherDEA NUMBER