Provider Demographics
NPI:1235860370
Name:DUONG, TORI NGOC (DPT)
Entity Type:Individual
Prefix:
First Name:TORI
Middle Name:NGOC
Last Name:DUONG
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4911 MENCHACA RD APT 255
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-1672
Mailing Address - Country:US
Mailing Address - Phone:510-928-0224
Mailing Address - Fax:
Practice Address - Street 1:3509 ROGGE LN
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78723-3640
Practice Address - Country:US
Practice Address - Phone:512-926-2070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-20
Last Update Date:2022-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1361480225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist