Healthcare Provider Details

I. General information

NPI: 1437043890
Provider Name (Legal Business Name): NGAN THANH VU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2025
Last Update Date: 06/09/2025
Certification Date: 06/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9707 ANDERSON MILL RD STE 340
AUSTIN TX
78750-0018
US

IV. Provider business mailing address

9707 ANDERSON MILL RD STE 340
AUSTIN TX
78750-0018
US

V. Phone/Fax

Practice location:
  • Phone: 512-258-5300
  • Fax: 512-258-4475
Mailing address:
  • Phone: 512-258-5300
  • Fax: 512-258-4475

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1406806
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: