Provider Demographics
NPI:1083099824
Name:DUONG, PETER TUYEN (DC)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:TUYEN
Last Name:DUONG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3213 RIDGE TRACE CIR
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-5365
Mailing Address - Country:US
Mailing Address - Phone:817-473-4348
Mailing Address - Fax:
Practice Address - Street 1:4200 SW GREEN OAKS BLVD STE 100
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76017-4162
Practice Address - Country:US
Practice Address - Phone:817-478-5800
Practice Address - Fax:817-478-5803
Is Sole Proprietor?:No
Enumeration Date:2015-07-22
Last Update Date:2019-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13007111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor