Provider Demographics
NPI:1538165022
Name:QUENG, THERESA C (MD,MPH)
Entity type:Individual
Prefix:
First Name:THERESA
Middle Name:C
Last Name:QUENG
Suffix:
Gender:F
Credentials:MD,MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4710 BELLAIRE BLVD
Mailing Address - Street 2:STE 200
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-4526
Mailing Address - Country:US
Mailing Address - Phone:713-661-1444
Mailing Address - Fax:713-661-6604
Practice Address - Street 1:4710 BELLAIRE BLVD
Practice Address - Street 2:STE 200
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-4526
Practice Address - Country:US
Practice Address - Phone:713-661-1444
Practice Address - Fax:713-661-6604
Is Sole Proprietor?:No
Enumeration Date:2005-06-21
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD6609207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXB25714Medicare UPIN