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NPI Code Detail

MEDICARE: THANH VU D.M.D.

MEDICARE:   THANH  VU  D.M.D.
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
11223G0001XGeneral Practice Dentistry33265TX

General Provider Information

NPI Number : 1689024515
Entity Type Code : Individual
Provider Name (Legal Business Name) : THANH VU D.M.D.
Provider Business Mailing Address
First Line : 3711 GREGORY ST
Second Line :
City : WICHITA FALLS
State : TX
Zip : 76308-1614
Country : US
Telephone Number : 940-228-1508
Fax Number :
Provider Business Practice Location Address
First Line : 3711 GREGORY ST
Second Line :
City : WICHITA FALLS
State : TX
Zip : 76308-1614
Country : US
Telephone Number : 940-228-1508
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2016
Last Update Date : 07/21/2022

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Directions to “ THANH VU D.M.D.” Practice Location

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