Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | T1327 | TX |
NPI | 1316472970 |
---|---|
Provider Name | Stephanie Ying Chu |
First Address | San Antonio, TX 78220-1013 |
Second Address | San Antonio, TX 78207-7161 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2017 |
Last Update Date | 07/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
425794101 | (05) | TX |