Provider Demographics
NPI:1881305365
Name:DU, VINH TUNG (AGPCNP-BC)
Entity type:Individual
Prefix:
First Name:VINH
Middle Name:TUNG
Last Name:DU
Suffix:
Gender:F
Credentials:AGPCNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 LEBANON ROAD
Mailing Address - Street 2:SUITE 112
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75036
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:255 LEBANON ROAD
Practice Address - Street 2:SUITE 112
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75036
Practice Address - Country:US
Practice Address - Phone:972-327-5524
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-06
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1097333363LA2200X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health