Healthcare Provider Details

I. General information

NPI: 1568474526
Provider Name (Legal Business Name): SU DUY DUONG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2006
Last Update Date: 04/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7011 SOUTHWEST FWY
HOUSTON TX
77074-2007
US

IV. Provider business mailing address

9401 SOUTHWEST FWY
HOUSTON TX
77074-1407
US

V. Phone/Fax

Practice location:
  • Phone: 713-970-7000
  • Fax: 713-970-7246
Mailing address:
  • Phone: 713-970-7687
  • Fax: 713-970-7246

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberH9624
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberH9624
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: