MEDICARE: TRUNG TRENT LUONG MD

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	207RN0300X	Nephrology Physician	N0934	TX

General Provider Information

NPI Number	:	1962611186
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRUNG TRENT LUONG MD

Provider Business Mailing Address
First Line	:	2323 MCCUE RD
Second Line	:	2104
City	:	HOUSTON
State	:	TX
Zip	:	77056-4683
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2323 MCCUE RD
Second Line	:	2104
City	:	HOUSTON
State	:	TX
Zip	:	77056-4683
Country	:	US
Telephone Number	:	713-980-5461
Fax Number	:

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

Provider Enumeration Date	:	05/22/2007
Last Update Date	:	10/14/2016

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