Healthcare Provider Details

I. General information

NPI: 1518222470
Provider Name (Legal Business Name): TAM DUONG M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2012
Last Update Date: 08/12/2022
Certification Date: 08/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6334 FM 2920 SUITE #300
SPRING TX
77379
US

IV. Provider business mailing address

6334 FM 2920 SUITE #300
SPRING TX
77379
US

V. Phone/Fax

Practice location:
  • Phone: 281-370-0616
  • Fax: 281-370-0609
Mailing address:
  • Phone: 281-370-0616
  • Fax: 281-370-0609

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberP3710
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: