1326437534 NPI number — DR. DONNY LUONG DPM

Table of content: DR. DONNY LUONG DPM (NPI 1326437534)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326437534 NPI number — DR. DONNY LUONG DPM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LUONG
Provider First Name:
DONNY
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DPM
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1326437534
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/23/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8333 BEECHNUT ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77036-6853
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-888-9920
Provider Business Mailing Address Fax Number:
281-974-2394

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8333 BEECHNUT ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77036-6853
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-888-9920
Provider Business Practice Location Address Fax Number:
281-974-2394
Provider Enumeration Date:
01/12/2015

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 213ES0103X , with the licence number:  006681 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 213ES0103X , with the licence number: 2134 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 347151805 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 347151801 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 347151803 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: P01571967 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 347151804 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 347151802 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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