Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | S1010 | TX |
NPI | 1003340886 |
---|---|
Provider Name | Linh Vo |
First Address | Red Oak, TX 75154-3830 |
Second Address | Red Oak, TX 75154-3830 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2017 |
Last Update Date | 11/11/2020 |