Provider Demographics
NPI:1902967151
Name:CHIU, CHUR CHILL (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHUR
Middle Name:CHILL
Last Name:CHIU
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8109 CULLEN BLVD
Mailing Address - Street 2:SUITE D
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77051-2064
Mailing Address - Country:US
Mailing Address - Phone:713-733-0733
Mailing Address - Fax:713-733-0733
Practice Address - Street 1:8109 CULLEN BLVD
Practice Address - Street 2:SUITE D
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77051-2064
Practice Address - Country:US
Practice Address - Phone:713-733-0733
Practice Address - Fax:713-733-0733
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18744122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0907164-01Medicaid