Provider Demographics
NPI:1427463751
Name:HO, DUYEN (DDS)
Entity type:Individual
Prefix:
First Name:DUYEN
Middle Name:
Last Name:HO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1860 TEXAS AVE
Mailing Address - Street 2:
Mailing Address - City:BRIDGE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77611-2808
Mailing Address - Country:US
Mailing Address - Phone:409-735-8146
Mailing Address - Fax:
Practice Address - Street 1:1860 TEXAS AVE
Practice Address - Street 2:
Practice Address - City:BRIDGE CITY
Practice Address - State:TX
Practice Address - Zip Code:77611-2808
Practice Address - Country:US
Practice Address - Phone:409-735-8146
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-25
Last Update Date:2014-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX300431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice