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General NPI Number Information
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NPI Number | 1306457023
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Entity Type | Individual
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Provider Name | AMY TRUONG LA DDS
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Gender | Female
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Dates
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Enumeration Date | 08/14/2020
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Last Update Date | 08/14/2020
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Provider Practice Location Address
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Address Line | 25201 KUYKENDAHL RD STE 450
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City | TOMBALL
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State | TX
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Zip | 77375-3352
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Country | US
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Telephone | 281-516-7100
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Fax |
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Provider Business Mailing Address
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Address Line | 100 DETERING ST APT 4153
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City | HOUSTON
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State | TX
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Zip | 77007-2368
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Country | US
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Telephone | 832-561-2307
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 36543
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License Number State | TX
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