MEDICARE: DR. VICKY V HUA DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	36528	TX

General Provider Information

NPI Number	:	1508477324
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VICKY V HUA DDS

Provider Business Mailing Address
First Line	:	7071 LAWNDALE ST STE D
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77023-4244
Country	:	US
Telephone Number	:	713-351-9437
Fax Number	:

Provider Business Practice Location Address
First Line	:	7071 LAWNDALE ST STE D
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77023-4244
Country	:	US
Telephone Number	:	713-351-9437
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/14/2020
Last Update Date	:	09/16/2020

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