Provider Demographics
NPI:1407882731
Name:THERIOT, VU DOAN (MD)
Entity Type:Individual
Prefix:DR
First Name:VU
Middle Name:DOAN
Last Name:THERIOT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:11511 SHADOW CREEK PKWY
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-7298
Mailing Address - Country:US
Mailing Address - Phone:713-442-0000
Mailing Address - Fax:
Practice Address - Street 1:5150 CRENSHAW RD
Practice Address - Street 2:SUITE A150
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77505-3094
Practice Address - Country:US
Practice Address - Phone:281-998-3210
Practice Address - Fax:281-998-3213
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH2832207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXH2832OtherSTATE LICENSE
TXP000F86M4Medicaid
TXP000F86M4Medicaid
TXH2832OtherSTATE LICENSE