Provider Demographics
NPI:1447850979
Name:LUU, VIVIAN WONG (PHARMD)
Entity type:Individual
Prefix:DR
First Name:VIVIAN
Middle Name:WONG
Last Name:LUU
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13710 HARTFORD CT
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77498-6316
Mailing Address - Country:US
Mailing Address - Phone:281-781-6008
Mailing Address - Fax:
Practice Address - Street 1:9460 W SAM HOUSTON PKWY S
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77099-1850
Practice Address - Country:US
Practice Address - Phone:281-568-3134
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-26
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63642183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist