Provider Demographics
NPI:1467141408
Name:VO, VINCENT VIET
Entity Type:Individual
Prefix:
First Name:VINCENT
Middle Name:VIET
Last Name:VO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4523 TRAPANI PORTA WAY
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449-6876
Mailing Address - Country:US
Mailing Address - Phone:832-812-0722
Mailing Address - Fax:
Practice Address - Street 1:1108 N OSTEOPATHY APT D
Practice Address - Street 2:
Practice Address - City:KIRKSVILLE
Practice Address - State:MO
Practice Address - Zip Code:63501-1200
Practice Address - Country:US
Practice Address - Phone:832-812-0722
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-04
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program