Provider Demographics
NPI:1518974047
Name:VUONG, TRI MINH (OD)
Entity Type:Individual
Prefix:DR
First Name:TRI
Middle Name:MINH
Last Name:VUONG
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9111 CLIFFSIDE DR
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75104
Mailing Address - Country:US
Mailing Address - Phone:972-283-3937
Mailing Address - Fax:
Practice Address - Street 1:3155 W WHEATLAND RD
Practice Address - Street 2:STE A
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75237-3453
Practice Address - Country:US
Practice Address - Phone:972-283-3937
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5652T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXV01493Medicare UPIN
TX00862XMedicare ID - Type UnspecifiedGRUOP MEDICARE
TX8D0217Medicare ID - Type UnspecifiedINDIVIDUAL MEDICARE