Healthcare Provider Details

I. General information

NPI: 1275851305
Provider Name (Legal Business Name): THAO VU M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2010
Last Update Date: 04/13/2021
Certification Date: 04/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 BLOSSOM ST STE 350
WEBSTER TX
77598-4243
US

IV. Provider business mailing address

PO BOX 650859 DEPT 710
DALLAS TX
75265-0859
US

V. Phone/Fax

Practice location:
  • Phone: 713-365-2900
  • Fax: 713-984-6525
Mailing address:
  • Phone: 409-747-6240
  • Fax: 409-747-1023

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberP9764
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: