Provider Demographics
NPI:1578077855
Name:TRUONG, JOSEPH N
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:N
Last Name:TRUONG
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 1:9222 ANGELAS MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77095-2155
Mailing Address - Country:US
Mailing Address - Phone:504-388-8564
Mailing Address - Fax:
Practice Address - Street 1:24919 WESTHEIMER PKWY
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-7313
Practice Address - Country:US
Practice Address - Phone:281-769-4210
Practice Address - Fax:281-769-4209
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-26
Last Update Date:2017-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX44684183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist