Provider Demographics
NPI:1982757019
Name:CHU, CUONG BA (DMD)
Entity Type:Individual
Prefix:DR
First Name:CUONG
Middle Name:BA
Last Name:CHU
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2944 S MASON RD STE E
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-1764
Mailing Address - Country:US
Mailing Address - Phone:281-693-3330
Mailing Address - Fax:281-693-3331
Practice Address - Street 1:2944 S MASON RD STE E
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-1764
Practice Address - Country:US
Practice Address - Phone:281-693-3330
Practice Address - Fax:281-693-3331
Is Sole Proprietor?:No
Enumeration Date:2007-01-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19891122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist