Healthcare Provider Details

I. General information

NPI: 1629273172
Provider Name (Legal Business Name): PAUL T TRUONG RRT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2352 FM 1960 RD W
HOUSTON TX
77068-3700
US

IV. Provider business mailing address

30723 VICTORIA ESTATES DR
SPRING TX
77386-2699
US

V. Phone/Fax

Practice location:
  • Phone: 281-587-8880
  • Fax: 281-587-8881
Mailing address:
  • Phone: 281-296-7135
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2279P1005X
TaxonomyPulmonary Rehabilitation Registered Respiratory Therapist
License Number54813
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: