Healthcare Provider Details

I. General information

NPI: 1992699656
Provider Name (Legal Business Name): VIAN VUONG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

2509 N MAIN ST
BELTON TX
76513-1551
US

IV. Provider business mailing address

2509 N MAIN ST
BELTON TX
76513-1551
US

V. Phone/Fax

Practice location:
  • Phone: 254-939-0843
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number41788
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: