Provider Demographics
NPI:1023062064
Name:VILIEN T DONG
Entity type:Organization
Organization Name:VILIEN T DONG
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:DONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-493-4718
Mailing Address - Street 1:3007 S DAIRY ASHFORD ST, STE#9
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-2302
Mailing Address - Country:US
Mailing Address - Phone:281-493-4718
Mailing Address - Fax:281-493-4716
Practice Address - Street 1:3007 S DAIRY ASHFORD ST STE 9
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-2303
Practice Address - Country:US
Practice Address - Phone:281-493-4718
Practice Address - Fax:281-493-4716
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX167896302Medicaid
TX167896301Medicaid
TX167896301Medicaid