Basic Information
| Provider Information | |||||||||
| NPI: | 1396724910 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | NGO | ||||||||
| FirstName: | DIEU RICK | ||||||||
| MiddleName: | QUANG | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 13811 MURPHY RD | ||||||||
| Address2: | |||||||||
| City: | STAFFORD | ||||||||
| State: | TX | ||||||||
| PostalCode: | 774774903 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7137721200 | ||||||||
| FaxNumber: | 2816933522 | ||||||||
| Practice Location | |||||||||
| Address1: | 920 FROSTWOOD DR STE 620 | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770242414 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7137721200 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/12/2006 | ||||||||
| LastUpdateDate: | 06/14/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/14/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | L4599 | TX | Y | Allopathic & Osteopathic Physicians | Surgery |
ID Information
| ID | Type | State | Issuer | Description | P00028473 | 01 | TX | MEDICARE RR | OTHER | 160826501 | 05 | TX | MEDICAID | 8G3690 | 01 | TX | BCBSTX | OTHER |