Provider Demographics
NPI:1801373394
Name:DOAN, TU MINH (DDS)
Entity Type:Individual
Prefix:
First Name:TU
Middle Name:MINH
Last Name:DOAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5006 LILLIAN ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77007-5336
Mailing Address - Country:US
Mailing Address - Phone:469-684-9105
Mailing Address - Fax:
Practice Address - Street 1:5006 LILLIAN ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77007-5336
Practice Address - Country:US
Practice Address - Phone:469-684-9105
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-26
Last Update Date:2018-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX34413122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist