Basic Information
| Provider Information | |||||||||
| NPI: | 1447850979 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LUU | ||||||||
| FirstName: | VIVIAN | ||||||||
| MiddleName: | WONG | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PHARMD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 13710 HARTFORD CT | ||||||||
| Address2: | |||||||||
| City: | SUGAR LAND | ||||||||
| State: | TX | ||||||||
| PostalCode: | 774986316 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2817816008 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 9460 W SAM HOUSTON PKWY S | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770991850 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2815683134 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/26/2020 | ||||||||
| LastUpdateDate: | 10/26/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/26/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 63642 | TX | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.