Individual
BAO NGOC TO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9111 WINKBOW DR, HOUSTON, TX 77040-1560
(865) 766-6870
(865) 766-0133
Mailing address
2001 LAUREL AVE # N304, KNOXVILLE, TN 37916-1810
(865) 766-6870
(865) 766-0133
Taxonomy
Speciality
Code
Description
License number
State
207U00000X
Nuclear Medicine Physician
A82593
CA
2085R0202X
Diagnostic Radiology Physician
Primary
68166
TN
2085R0202X
Diagnostic Radiology Physician
M9699
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
280139101
—
TX
01
—
8CU599
BCBS
TX
Enumeration date
05/18/2009
Last updated
04/05/2023
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