Provider Demographics
NPI:1427461896
Name:VU, HENRY
Entity type:Individual
Prefix:
First Name:HENRY
Middle Name:
Last Name:VU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10961 GATEWAY WEST
Mailing Address - Street 2:STE 300
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79935
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10961 GATEWAY WEST
Practice Address - Street 2:STE 300
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79935
Practice Address - Country:US
Practice Address - Phone:915-519-2639
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-03
Last Update Date:2016-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14906152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist