Provider Demographics
NPI:1124195433
Name:THAI, BAO VUONG (DC)
Entity Type:Individual
Prefix:DR
First Name:BAO
Middle Name:VUONG
Last Name:THAI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6853 COIT RD.
Mailing Address - Street 2:STE 200
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-5466
Mailing Address - Country:US
Mailing Address - Phone:972-491-1400
Mailing Address - Fax:972-491-1440
Practice Address - Street 1:6853 COIT RD.
Practice Address - Street 2:STE 200
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-5466
Practice Address - Country:US
Practice Address - Phone:972-491-1400
Practice Address - Fax:972-491-1440
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10398111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor