MEDICARE: MRS. TIEN VU WHNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LW0102X	Women's Health Nurse Practitioner	758629	TX

General Provider Information

NPI Number	:	1003328964
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TIEN VU WHNP-BC

Provider Business Mailing Address
First Line	:	6750 N MACARTHUR BLVD STE 211
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75039-2473
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6750 N MACARTHUR BLVD STE 211
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75039-2473
Country	:	US
Telephone Number	:	214-647-1533
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/01/2017
Last Update Date	:	11/01/2017

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