Healthcare Provider Details

I. General information

NPI: 1831610203
Provider Name (Legal Business Name): JENNIFER VUONG O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2017
Last Update Date: 09/29/2024
Certification Date: 09/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1533 N SHEPHERD DR STE 120
HOUSTON TX
77008-4180
US

IV. Provider business mailing address

914 CULLEN BLVD
HOUSTON TX
77023-1653
US

V. Phone/Fax

Practice location:
  • Phone: 832-975-7020
  • Fax: 832-975-7021
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number9220T
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: