Provider Demographics
NPI:1114460532
Name:VO, PHUNG (NP-C)
Entity Type:Individual
Prefix:MISS
First Name:PHUNG
Middle Name:
Last Name:VO
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5907 CIELO RNCH
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78218-4164
Mailing Address - Country:US
Mailing Address - Phone:972-342-8410
Mailing Address - Fax:
Practice Address - Street 1:8235 S NEW BRAUNFELS STE 101
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78235-4439
Practice Address - Country:US
Practice Address - Phone:210-616-1317
Practice Address - Fax:210-333-0633
Is Sole Proprietor?:No
Enumeration Date:2016-12-03
Last Update Date:2019-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX786709363LF0000X
TXAP132768363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily