Individual
CHARLES YIENG CHU SU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1901 N MACARTHUR BLVD, IRVING, TX 75061-2220
(972) 579-8110
Mailing address
505 SAINT LAURENT CT, SOUTHLAKE, TX 76092-5874
(817) 329-4792
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
J3383
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
089938702
—
TX
01
—
089938703
CSHCN
TX
01
—
82251F
BCBS
TX
Enumeration date
10/06/2005
Last updated
03/26/2008
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