Provider Demographics
NPI:1184967242
Name:HU, JERRY (DO PHARMD)
Entity type:Individual
Prefix:DR
First Name:JERRY
Middle Name:
Last Name:HU
Suffix:
Gender:M
Credentials:DO PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:425 W COLONIAL DR STE 303
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-6863
Mailing Address - Country:US
Mailing Address - Phone:321-343-6833
Mailing Address - Fax:407-286-4515
Practice Address - Street 1:1770 STATE HIGHWAY 46 W STE 12001770
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78132-5391
Practice Address - Country:US
Practice Address - Phone:830-730-4375
Practice Address - Fax:830-730-4203
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-27
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102204002207R00000X
WAOP60926835207R00000X, 208D00000X
TXT8227207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty