Provider Demographics
NPI:1982604971
Name:VU, QUYNH N (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:QUYNH
Middle Name:N
Last Name:VU
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2705 GLEN HEATHER DR
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75082-3829
Mailing Address - Country:US
Mailing Address - Phone:214-477-5358
Mailing Address - Fax:
Practice Address - Street 1:750 W FM 544
Practice Address - Street 2:
Practice Address - City:WYLIE
Practice Address - State:TX
Practice Address - Zip Code:75098-3913
Practice Address - Country:US
Practice Address - Phone:866-389-2727
Practice Address - Fax:401-216-3854
Is Sole Proprietor?:No
Enumeration Date:2005-07-30
Last Update Date:2019-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA00070363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX182874101Medicaid
TX182874106Medicaid
TX185855701Medicaid
TX185855702Medicaid
TX185855703Medicaid
TX8N4445OtherBLUE CROSS BLUE SHIELD
TX182874104Medicaid
TX182874105Medicaid
TX185855702Medicaid
82N828Medicare PIN