Provider Demographics
NPI:1720305089
Name:LUU, DIEM (RPH)
Entity type:Individual
Prefix:
First Name:DIEM
Middle Name:
Last Name:LUU
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:DINA
Other - Middle Name:
Other - Last Name:LUU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RPH
Mailing Address - Street 1:7004 AVIGNON DR
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681-5331
Mailing Address - Country:US
Mailing Address - Phone:512-524-7727
Mailing Address - Fax:
Practice Address - Street 1:9414 N LAMAR BLVD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78753-4106
Practice Address - Country:US
Practice Address - Phone:512-837-9580
Practice Address - Fax:512-835-1129
Is Sole Proprietor?:No
Enumeration Date:2010-04-27
Last Update Date:2010-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX35930183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist