Basic Information
| Provider Information | |||||||||
| NPI: | 1972825222 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHU | ||||||||
| FirstName: | THOMAS | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5841 E. CHARLESTON BOULVARD | ||||||||
| Address2: | 230-479 | ||||||||
| City: | LAS VEGAS | ||||||||
| State: | NEVADA | ||||||||
| PostalCode: | 89142 | ||||||||
| CountryCode: | UM | ||||||||
| TelephoneNumber: | 7027348014 | ||||||||
| FaxNumber: | 7027346677 | ||||||||
| Practice Location | |||||||||
| Address1: | 9020 W CHEYENNE AVE | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891298932 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7022404233 | ||||||||
| FaxNumber: | 7022425901 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/26/2010 | ||||||||
| LastUpdateDate: | 02/26/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | PA1196 | NV | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.