Healthcare Provider Details

I. General information

NPI: 1497624035
Provider Name (Legal Business Name): LINH VUONG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2025
Last Update Date: 11/03/2025
Certification Date: 11/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3008 SUDHA DR
AUSTIN TX
78728-4432
US

IV. Provider business mailing address

1515 HOLCOMBE BLVD
HOUSTON TX
77030-4000
US

V. Phone/Fax

Practice location:
  • Phone: 360-451-8511
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number75886
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: