Healthcare Provider Details

I. General information

NPI: 1093693095
Provider Name (Legal Business Name): VINH VU, DO PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2025
Last Update Date: 08/26/2025
Certification Date: 08/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3119 IVY HILL LN
IRVING TX
75063-0167
US

IV. Provider business mailing address

3119 IVY HILL LN
IRVING TX
75063-0167
US

V. Phone/Fax

Practice location:
  • Phone: 714-487-2143
  • Fax:
Mailing address:
  • Phone: 714-487-2143
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code283X00000X
TaxonomyRehabilitation Hospital
License Number
License Number State

VIII. Authorized Official

Name: VINH VU
Title or Position: SOLE PROPRIETOR
Credential: DO
Phone: 714-487-2143