Provider Demographics
NPI:1073675468
Name:THANG HOANG, M.D., P.A.
Entity Type:Organization
Organization Name:THANG HOANG, M.D., P.A.
Other - Org Name:VITALCARE MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THANG
Authorized Official - Middle Name:
Authorized Official - Last Name:HOANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-482-9994
Mailing Address - Street 1:1816 BROADWAY ST
Mailing Address - Street 2:STE 110
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77581-5664
Mailing Address - Country:US
Mailing Address - Phone:281-482-9994
Mailing Address - Fax:281-482-2231
Practice Address - Street 1:1816 BROADWAY ST
Practice Address - Street 2:STE 110
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77581-5664
Practice Address - Country:US
Practice Address - Phone:281-482-9994
Practice Address - Fax:281-482-2231
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK7167207R00000X, 208000000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX167045701Medicaid
TX167045702Medicaid
TX00787WMedicare PIN
TX110245866Medicare PIN
H41767Medicare UPIN