Individual
CHUNG-CHIEH LO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3101 HIGHWAY 71 E STE 211, BASTROP, TX 78602-5157
(855) 876-7246
(855) 277-5070
Mailing address
PO BOX 208357, DALLAS, TX 75320-8357
(512) 485-7208
(844) 364-8678
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
BP1 - 0040943
TX
208VP0014X
Interventional Pain Medicine Physician
Primary
S0499
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1K5259
TEXAS MEDICARE
TX
01
—
BP1 - 0040943
PIT PERMIT NUMBER
TX
01
—
S0499
TEXAS MEDICAL LICENSE
TX
Enumeration date
05/26/2011
Last updated
03/08/2023
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