Provider Demographics
NPI:1225058134
Name:DOLA, THAO PHUONG (MD)
Entity Type:Individual
Prefix:DR
First Name:THAO
Middle Name:PHUONG
Last Name:DOLA
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:18044 OLD COVINGTON HWY
Mailing Address - Street 2:APT 309
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70403-0659
Mailing Address - Country:US
Mailing Address - Phone:504-512-1753
Mailing Address - Fax:985-340-3834
Practice Address - Street 1:1135 SOUTH MORRISON BLVD
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403
Practice Address - Country:US
Practice Address - Phone:985-340-7816
Practice Address - Fax:985-340-3834
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
LA022120207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine