Individual
MANHAN KHAC VU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
855 MONTGOMERY ST, DEPT OF OB/GYN, FORT WORTH, TX 76107-2553
(817) 735-2198
Mailing address
PO BOX 99335, FORT WORTH, TX 76199-0335
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
M4627
TX
207VF0040X
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
Primary
M4627
TX
390200000X
Student in an Organized Health Care Education/Training Program
M4627
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
284006801
—
TX
01
—
8CW320
BCBS
TX
01
—
P01031534
RAILROAD MEDICARE
TX
Enumeration date
06/07/2007
Last updated
01/20/2017
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