Provider Demographics
NPI:1437592151
Name:VO, THERESA THUY (MD)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:THUY
Last Name:VO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7105 LAKEVIEW PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:ROWLETT
Mailing Address - State:TX
Mailing Address - Zip Code:75088-4202
Mailing Address - Country:US
Mailing Address - Phone:504-606-5558
Mailing Address - Fax:972-695-8410
Practice Address - Street 1:7105 LAKEVIEW PKWY STE 100
Practice Address - Street 2:
Practice Address - City:ROWLETT
Practice Address - State:TX
Practice Address - Zip Code:75088-4202
Practice Address - Country:US
Practice Address - Phone:972-475-5300
Practice Address - Fax:972-695-8410
Is Sole Proprietor?:No
Enumeration Date:2013-04-11
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ9073207Q00000X
TXQ0973207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX358367601Medicaid
TX358367602OtherCSHCN
TX492443YK00Medicare UPIN