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General NPI Number Information
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NPI Number | 1487820213
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Entity Type | Individual
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Provider Name | KHANH CONG VU D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 05/01/2008
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Last Update Date | 05/01/2008
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Provider Practice Location Address
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Address Line | 7515 W BELLFORT ST
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City | HOUSTON
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State | TX
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Zip | 77071-2101
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Country | US
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Telephone | 713-723-7855
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Fax | 713-723-5772
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Provider Business Mailing Address
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Address Line | 12790 VETERANS MEMORIAL DR
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City | HOUSTON
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State | TX
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Zip | 77014-2048
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Country | US
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Telephone | 281-580-7620
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Fax | 281-580-0466
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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 | 21743
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License Number State | TX
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