Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | R3343 | TX |
NPI | 1205151545 |
---|---|
Provider Name | Trung Quang Ho |
First Address | Lufkin, TX 75904-3320 |
Second Address | Lufkin, TX 75904-3320 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2010 |
Last Update Date | 28/02/2019 |