Provider Demographics
NPI:1083098453
Name:TMAA, PLLC
Entity Type:Organization
Organization Name:TMAA, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:TUONG
Authorized Official - Middle Name:
Authorized Official - Last Name:TA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:817-428-7704
Mailing Address - Street 1:4109 BROWN TRAIL
Mailing Address - Street 2:SUITE 102
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76304-3940
Mailing Address - Country:US
Mailing Address - Phone:181-742-8770
Mailing Address - Fax:
Practice Address - Street 1:4109 BROWN TRAIL
Practice Address - Street 2:SUITE 102
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76304-3940
Practice Address - Country:US
Practice Address - Phone:181-742-8770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-16
Last Update Date:2015-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty