Provider Demographics
NPI:1447451042
Name:TRUONG, TUAN ANH (MD)
Entity type:Individual
Prefix:
First Name:TUAN
Middle Name:ANH
Last Name:TRUONG
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 1:410 GENESIS BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-1640
Mailing Address - Country:US
Mailing Address - Phone:832-835-1131
Mailing Address - Fax:
Practice Address - Street 1:410 GENESIS BLVD STE A
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-1640
Practice Address - Country:US
Practice Address - Phone:832-835-1131
Practice Address - Fax:832-918-3223
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTRN11017208600000X
AZ463142086S0122X
TXQ64742086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery