Provider Demographics
NPI:1285727024
Name:DUKE P VU PA
Entity type:Organization
Organization Name:DUKE P VU PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DUKE
Authorized Official - Middle Name:P
Authorized Official - Last Name:VU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-999-7601
Mailing Address - Street 1:13420 STATE HIGHWAY 249
Mailing Address - Street 2:SUITE I
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77086-3167
Mailing Address - Country:US
Mailing Address - Phone:281-999-7601
Mailing Address - Fax:281-999-7881
Practice Address - Street 1:13420 STATE HIGHWAY 249
Practice Address - Street 2:SUITE I
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77086-3167
Practice Address - Country:US
Practice Address - Phone:281-999-7601
Practice Address - Fax:281-999-7881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2012-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM3419207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00X367Medicare PIN