Healthcare Provider Details

I. General information

NPI: 1164799094
Provider Name (Legal Business Name): THANH NGO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2011
Last Update Date: 07/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8000 RESEARCH FOREST DR SUITE 360
THE WOODLANDS TX
77382-1504
US

IV. Provider business mailing address

8000 RESEARCH FOREST DR SUITE 360
THE WOODLANDS TX
77382-1504
US

V. Phone/Fax

Practice location:
  • Phone: 281-292-1192
  • Fax: 281-362-9170
Mailing address:
  • Phone: 281-292-1192
  • Fax: 281-362-9170

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberP9921
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: