Provider Demographics
NPI:1205272945
Name:DUONG, THAO (MD)
Entity type:Individual
Prefix:DR
First Name:THAO
Middle Name:
Last Name:DUONG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:2550 N ESPLANADE ST
Mailing Address - Street 2:
Mailing Address - City:CUERO
Mailing Address - State:TX
Mailing Address - Zip Code:77954-4736
Mailing Address - Country:US
Mailing Address - Phone:361-275-6191
Mailing Address - Fax:361-275-3999
Practice Address - Street 1:19550 E 39TH ST S
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64057-2358
Practice Address - Country:US
Practice Address - Phone:913-307-5812
Practice Address - Fax:816-833-1760
Is Sole Proprietor?:No
Enumeration Date:2013-05-21
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ1591207RC0000X
CAA142202207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease