Provider Demographics
NPI:1811221534
Name:TSAI, AMY JEW (MD)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:JEW
Last Name:TSAI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:
Other - Last Name:JEW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 270898
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77277-0898
Mailing Address - Country:US
Mailing Address - Phone:713-796-0003
Mailing Address - Fax:713-796-0005
Practice Address - Street 1:5615 KIRBY DRIVE
Practice Address - Street 2:SUITE 440
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77005-2444
Practice Address - Country:US
Practice Address - Phone:713-796-0003
Practice Address - Fax:713-796-0005
Is Sole Proprietor?:No
Enumeration Date:2009-09-28
Last Update Date:2013-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXN67272080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX085387101Medicaid