Healthcare Provider Details

I. General information

NPI: 1316094246
Provider Name (Legal Business Name): QUANG THE VU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/04/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3709 WESTBANK EXPY STE 1B
HARVEY LA
70058-2600
US

IV. Provider business mailing address

3709 WESTBANK EXPY STE 1B
HARVEY LA
70058-2600
US

V. Phone/Fax

Practice location:
  • Phone: 504-348-2310
  • Fax: 504-348-1942
Mailing address:
  • Phone: 504-348-2310
  • Fax: 504-348-1942

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RA0000X
TaxonomyAdolescent Medicine (Internal Medicine) Physician
License Number024975
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number024975
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: