Provider Demographics
NPI:1982048906
Name:TRUONG, ANH LAN (MD)
Entity Type:Individual
Prefix:MS
First Name:ANH
Middle Name:LAN
Last Name:TRUONG
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 1:3511 BELLEFONTAINE ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77025-1309
Mailing Address - Country:US
Mailing Address - Phone:832-526-1411
Mailing Address - Fax:
Practice Address - Street 1:1977 BUTLER BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-4101
Practice Address - Country:US
Practice Address - Phone:713-798-4068
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-21
Last Update Date:2013-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP100462112084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXBP10046211OtherTEXAS MEDICAL BOARD PHYSICIAN IN TRAINING PERMIT