Provider Demographics
NPI:1609225572
Name:TRUONG, THANH-THAO (MD)
Entity Type:Individual
Prefix:
First Name:THANH-THAO
Middle Name:
Last Name:TRUONG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8278 BELLAIRE BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-4091
Mailing Address - Country:US
Mailing Address - Phone:713-272-8858
Mailing Address - Fax:713-995-6142
Practice Address - Street 1:8278 BELLAIRE BLVD STE A
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-4091
Practice Address - Country:US
Practice Address - Phone:713-272-8858
Practice Address - Fax:713-995-6142
Is Sole Proprietor?:No
Enumeration Date:2016-06-10
Last Update Date:2019-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS3602207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine