Provider Demographics
NPI:1740202910
Name:TRUONG, THAO MINH (MD)
Entity type:Individual
Prefix:DR
First Name:THAO
Middle Name:MINH
Last Name:TRUONG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:827 MAGNOLIA BLVD STE 6
Mailing Address - Street 2:
Mailing Address - City:MAGNOLIA
Mailing Address - State:TX
Mailing Address - Zip Code:77355-8553
Mailing Address - Country:US
Mailing Address - Phone:281-259-7400
Mailing Address - Fax:888-502-3566
Practice Address - Street 1:827 MAGNOLIA BLVD STE 6
Practice Address - Street 2:
Practice Address - City:MAGNOLIA
Practice Address - State:TX
Practice Address - Zip Code:77355-8553
Practice Address - Country:US
Practice Address - Phone:281-259-7400
Practice Address - Fax:888-502-3566
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2025-11-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXK2128207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXK2128OtherSTATE LICENSE
TXG69853Medicare UPIN
TXTXB148484OtherMEDICARE
TX8B5116Medicare ID - Type Unspecified
TXTXK2128OtherTX STATE LICENSE