Provider Demographics
NPI:1962726794
Name:VU, DONNA
Entity type:Individual
Prefix:DR
First Name:DONNA
Middle Name:
Last Name:VU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 DOCTOR CIR
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75605-5050
Mailing Address - Country:US
Mailing Address - Phone:903-757-3881
Mailing Address - Fax:903-757-5948
Practice Address - Street 1:6 DOCTOR CIR
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75605-5050
Practice Address - Country:US
Practice Address - Phone:903-757-3881
Practice Address - Fax:903-757-5948
Is Sole Proprietor?:No
Enumeration Date:2010-03-23
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP6544207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX293216YSYBOtherMEDICARE INDIVIDUAL PTAN
TX10197662OtherDPS LICENSE
TXTXB145668OtherMEDICARE GROUP PTAN
TXTXB145668OtherMEDICARE GROUP PTAN