Provider Demographics
NPI:1609041789
Name:VO, PHUC H (DO)
Entity Type:Individual
Prefix:
First Name:PHUC
Middle Name:H
Last Name:VO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:PHUC
Other - Middle Name:H
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:720 N DENTON TAP RD
Mailing Address - Street 2:
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-2162
Mailing Address - Country:US
Mailing Address - Phone:469-312-3080
Mailing Address - Fax:
Practice Address - Street 1:720 N DENTON TAP RD
Practice Address - Street 2:
Practice Address - City:COPPELL
Practice Address - State:TX
Practice Address - Zip Code:75019-2162
Practice Address - Country:US
Practice Address - Phone:469-312-3080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-29
Last Update Date:2015-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN8131207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX282752901Medicaid
TXP01003032OtherRAILROAD
TX282752902Medicaid
TXTXB130896Medicare PIN
TXTXB130895Medicare PIN