Healthcare Provider Details

I. General information

NPI: 1346332186
Provider Name (Legal Business Name): NGHIA QUANG VUONG DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11169 BEECHNUT STREET SUITE # A
HOUSTON TX
77072
US

IV. Provider business mailing address

11169 BEECHNUT STREET SUITE # A
HOUSTON TX
77072
US

V. Phone/Fax

Practice location:
  • Phone: 281-498-6687
  • Fax: 281-498-7449
Mailing address:
  • Phone: 281-498-6687
  • Fax: 281-498-7449

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number13574
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: