Provider Demographics
NPI:1245518836
Name:LUU, PHUONG QUE (MD)
Entity type:Individual
Prefix:DR
First Name:PHUONG
Middle Name:QUE
Last Name:LUU
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 1:10422 CANYONCREST LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77086-1752
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1640 LAKE WOODLANDS DR
Practice Address - Street 2:SUITE # E
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-3276
Practice Address - Country:US
Practice Address - Phone:281-367-0010
Practice Address - Fax:832-482-3479
Is Sole Proprietor?:No
Enumeration Date:2011-07-30
Last Update Date:2013-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN9255208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics