Provider Demographics
NPI:1821372160
Name:ALLURE SKIN AND WELLNESS CENTER LLC
Entity Type:Organization
Organization Name:ALLURE SKIN AND WELLNESS CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PHONG
Authorized Official - Middle Name:THE
Authorized Official - Last Name:LUU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-568-5550
Mailing Address - Street 1:10613 BELLAIRE BLVD
Mailing Address - Street 2:A105
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77072-5221
Mailing Address - Country:US
Mailing Address - Phone:281-568-5555
Mailing Address - Fax:832-274-8807
Practice Address - Street 1:10613 BELLAIRE BLVD
Practice Address - Street 2:A105
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77072-5221
Practice Address - Country:US
Practice Address - Phone:281-568-5555
Practice Address - Fax:832-274-8807
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-05
Last Update Date:2011-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ7348207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty