Provider Demographics
NPI:1881913754
Name:CHUNG, PUI Y (PT)
Entity type:Individual
Prefix:MS
First Name:PUI
Middle Name:Y
Last Name:CHUNG
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:PANCY
Other - Middle Name:
Other - Last Name:CHUNG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:1226 GLENWOOD CANYON LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77077-1055
Mailing Address - Country:US
Mailing Address - Phone:512-750-1628
Mailing Address - Fax:
Practice Address - Street 1:1226 GLENWOOD CANYON LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077-1055
Practice Address - Country:US
Practice Address - Phone:512-750-1628
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-18
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1173343225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist