Provider Demographics
NPI:1962611186
Name:LUONG, TRUNG TRENT (MD)
Entity type:Individual
Prefix:
First Name:TRUNG
Middle Name:TRENT
Last Name:LUONG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2323 MCCUE RD
Mailing Address - Street 2:2104
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77056-4683
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2323 MCCUE RD
Practice Address - Street 2:2104
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77056-4683
Practice Address - Country:US
Practice Address - Phone:713-980-5461
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2016-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN0934207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB150962Medicare PIN