Provider Demographics
NPI:1316094246
Name:VU, QUANG THE (MD)
Entity type:Individual
Prefix:DR
First Name:QUANG
Middle Name:THE
Last Name:VU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3709 WESTBANK EXPY STE 1B
Mailing Address - Street 2:
Mailing Address - City:HARVEY
Mailing Address - State:LA
Mailing Address - Zip Code:70058-2600
Mailing Address - Country:US
Mailing Address - Phone:504-348-2310
Mailing Address - Fax:504-348-1942
Practice Address - Street 1:3709 WESTBANK EXPY STE 1B
Practice Address - Street 2:
Practice Address - City:HARVEY
Practice Address - State:LA
Practice Address - Zip Code:70058-2600
Practice Address - Country:US
Practice Address - Phone:504-348-2310
Practice Address - Fax:504-348-1942
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA024975207RA0000X, 2080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207RA0000XAllopathic & Osteopathic PhysiciansInternal MedicineAdolescent Medicine
Not Answered2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1422321Medicaid
LA1422321Medicaid
LAI18683Medicare UPIN