Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | M4627 | TX |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | M4627 | TX |
NPI | 1255534285 |
---|---|
Provider Name | Manhan Khac Vu |
First Address | Fort Worth, TX 76199-0335 |
Second Address | Fort Worth, TX 76107-2553 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2007 |
Last Update Date | 20/01/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
284006801 | (05) | TX |
8CW320 | BCBS (01) | TX |
P01031534 | RAILROAD MEDICARE (01) | TX |