MEDICARE: LOAN THI MINH VO FNP-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	363LF0000X	Family Nurse Practitioner	1017786	TX

General Provider Information

NPI Number	:	1245800903
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LOAN THI MINH VO FNP-BC

Provider Business Mailing Address
First Line	:	11511 SHADOW CREEK PKWY
Second Line	:
City	:	PEARLAND
State	:	TX
Zip	:	77584-7298
Country	:	US
Telephone Number	:	713-442-0000
Fax Number	:

Provider Business Practice Location Address
First Line	:	12924 BELLAIRE BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77072-5131
Country	:	US
Telephone Number	:	832-217-0827
Fax Number	:

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

Provider Enumeration Date	:	06/25/2021
Last Update Date	:	09/18/2023

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