Provider Demographics
NPI:1104943281
Name:DURAN, LIEU NGO (MD)
Entity type:Individual
Prefix:DR
First Name:LIEU
Middle Name:NGO
Last Name:DURAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12803 BROOK ARBOR CT
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-2562
Mailing Address - Country:US
Mailing Address - Phone:832-681-1967
Mailing Address - Fax:
Practice Address - Street 1:22678 HIGHWAY 59
Practice Address - Street 2:
Practice Address - City:PORTER
Practice Address - State:TX
Practice Address - Zip Code:77365-6699
Practice Address - Country:US
Practice Address - Phone:281-354-4654
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM5404207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX187834004Medicaid
TX8AC847OtherBCBSTX PROV. NUMBER
TX8AC847OtherBCBSTX PROV. NUMBER
TX8K4043Medicare UPIN
TX187834004Medicaid