Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 758629 | TX |
NPI | 1003328964 |
---|---|
Provider Name | Mrs. Tien Vu |
First Address | Irving, TX 75039-2473 |
Second Address | Irving, TX 75039-2473 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2017 |
Last Update Date | 01/11/2017 |