Healthcare Provider Details

I. General information

NPI: 1891374294
Provider Name (Legal Business Name): ASHLEY TRUC KHA NGO DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/05/2021
Last Update Date: 10/15/2024
Certification Date: 10/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16537 SOUTHWEST FREEWAY, MOB4 SUITE 600
SUGAR LAND TX
77479
US

IV. Provider business mailing address

424 HAHLO ST
HOUSTON TX
77020-3022
US

V. Phone/Fax

Practice location:
  • Phone: 281-275-0800
  • Fax: 281-275-0801
Mailing address:
  • Phone: 713-674-3326
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberU2588
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: