Provider Demographics
NPI:1366407918
Name:VU, THUAN QUANG (MD)
Entity type:Individual
Prefix:
First Name:THUAN
Middle Name:QUANG
Last Name:VU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1260 HARWOOD RD
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76021-4244
Mailing Address - Country:US
Mailing Address - Phone:817-358-0100
Mailing Address - Fax:817-358-0125
Practice Address - Street 1:1260 HARWOOD RD
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76021-4244
Practice Address - Country:US
Practice Address - Phone:817-358-0100
Practice Address - Fax:817-358-0125
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2008-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ8412207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX100150501Medicaid
TX66000157OtherMEDICARE RAILROAD
TX83Y530Medicare PIN