Provider Demographics
NPI:1578696142
Name:TRUONG, MICHAEL VAN (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:VAN
Last Name:TRUONG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13611 BELLAIRE BLVD STE D
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77083-1701
Mailing Address - Country:US
Mailing Address - Phone:281-879-8118
Mailing Address - Fax:281-879-8119
Practice Address - Street 1:13611 BELLAIRE BLVD STE D
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77083-1701
Practice Address - Country:US
Practice Address - Phone:281-879-8118
Practice Address - Fax:281-879-8119
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDC6492111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor