Provider Demographics
NPI:1659367712
Name:NGO, VY J (DO)
Entity Type:Individual
Prefix:DR
First Name:VY
Middle Name:J
Last Name:NGO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7112 ED BLUESTEIN BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-2913
Mailing Address - Country:US
Mailing Address - Phone:512-744-6000
Mailing Address - Fax:512-928-8393
Practice Address - Street 1:7112 ED BLUESTEIN BLVD STE 100
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78723-2913
Practice Address - Country:US
Practice Address - Phone:512-744-6000
Practice Address - Fax:512-928-8393
Is Sole Proprietor?:No
Enumeration Date:2005-09-23
Last Update Date:2007-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL8862208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
I08535Medicare UPIN
8B9640Medicare ID - Type Unspecified