Provider Demographics
NPI:1255727632
Name:CHU, BRANDON PITA (DO)
Entity type:Individual
Prefix:MR
First Name:BRANDON
Middle Name:PITA
Last Name:CHU
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2403 TAPIO CIR
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105-2287
Mailing Address - Country:US
Mailing Address - Phone:832-277-8904
Mailing Address - Fax:
Practice Address - Street 1:1941 EAST RD STE 3236
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-6010
Practice Address - Country:US
Practice Address - Phone:713-486-2570
Practice Address - Fax:713-486-2565
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-12
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS17882084P0804X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program