Healthcare Provider Details

I. General information

NPI: 1871173757
Provider Name (Legal Business Name): TRACEY VUONG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2021
Last Update Date: 07/31/2024
Certification Date: 07/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10101 WESTRIDGE BLVD STE 101
MCKINNEY TX
75072-5922
US

IV. Provider business mailing address

10101 WESTRIDGE BLVD STE 101
MCKINNEY TX
75072-5922
US

V. Phone/Fax

Practice location:
  • Phone: 972-645-9400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberU7535
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: