Provider Demographics
NPI:1326381286
Name:LUU, TINA THU NGA (MD)
Entity type:Individual
Prefix:
First Name:TINA
Middle Name:THU NGA
Last Name:LUU
Suffix:
Gender:F
Credentials:MD
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Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:18700 KATY FREEWAY
Mailing Address - Street 2:MEDICAL OFFICE BUILDING 3, SUITE 403
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77094
Mailing Address - Country:US
Mailing Address - Phone:832-522-8444
Mailing Address - Fax:832-522-8445
Practice Address - Street 1:18700 KATY FREEWAY
Practice Address - Street 2:MEDICAL OFFICE BUILDING 3, SUITE 403
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77094
Practice Address - Country:US
Practice Address - Phone:832-522-8444
Practice Address - Fax:832-522-8445
Is Sole Proprietor?:No
Enumeration Date:2013-03-28
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXQ9188207Q00000X
OH127750261QP2300X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX364941003Medicaid