Provider Demographics
NPI:1811307390
Name:DO, CHI L (PA-C)
Entity type:Individual
Prefix:
First Name:CHI
Middle Name:L
Last Name:DO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:C
Other - Last Name:DO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:10720 BARKER CYPRESS RD
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-1372
Mailing Address - Country:US
Mailing Address - Phone:281-345-4800
Mailing Address - Fax:281-345-4803
Practice Address - Street 1:10720 BARKER CYPRESS RD
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-1372
Practice Address - Country:US
Practice Address - Phone:281-345-4800
Practice Address - Fax:281-345-4803
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-06
Last Update Date:2019-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA09142363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant