Provider Demographics
NPI: | 1063462547 |
---|---|
Name: | VO, DUC P (MD) |
Entity type: | Individual |
Prefix: | |
First Name: | DUC |
Middle Name: | P |
Last Name: | VO |
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: | 2241 PEGGY LN |
Mailing Address - Street 2: | SUITE A |
Mailing Address - City: | GARLAND |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 75042-5732 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 972-276-0536 |
Mailing Address - Fax: | 972-276-6037 |
Practice Address - Street 1: | 2821 E PRESIDENT GEORGE BUSH HWY STE 306 |
Practice Address - Street 2: | |
Practice Address - City: | RICHARDSON |
Practice Address - State: | TX |
Practice Address - Zip Code: | 75082-4277 |
Practice Address - Country: | US |
Practice Address - Phone: | 197-267-5950 |
Practice Address - Fax: | 972-675-9400 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2006-05-12 |
Last Update Date: | 2021-09-08 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
TX | K4825 | 207X00000X, 207XS0106X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 207XS0106X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Hand Surgery |
No | 207X00000X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
TX | 84594Y | Other | BCBS |
TX | G69582 | Medicare UPIN | |
TX | 8D6940 | Medicare ID - Type Unspecified |