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Individual
PHUONG LUU
Active
Individual
PHUONG LUU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
000957
CT
363A00000X
Physician Assistant
Primary
PA05428
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
191512601
—
TX
01
—
290000957CT02
BCBS
CT
01
—
752616977008
TRICARE
TX
01
—
8Y3171
BCBS OF TEXAS
TX
01
—
9490683
PHCS
TX
Enumeration date
12/23/2005
Last updated
11/13/2013
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