Provider Demographics
NPI:1114218658
Name:TRIET Q HUYNH MD PA
Entity Type:Organization
Organization Name:TRIET Q HUYNH MD PA
Other - Org Name:CRENSHAW INTERVENTIONAL PAIN SPECIALIST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TRIET
Authorized Official - Middle Name:
Authorized Official - Last Name:HUYNH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-487-6057
Mailing Address - Street 1:5150 CRENSHAW RD STE B100
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77505-3095
Mailing Address - Country:US
Mailing Address - Phone:281-487-6057
Mailing Address - Fax:713-947-6080
Practice Address - Street 1:5150 CRENSHAW RD STE B100
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77505-3095
Practice Address - Country:US
Practice Address - Phone:281-487-6057
Practice Address - Fax:713-947-6080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-01
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ00102081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB134645OtherPTAN# GROUP
TXTXB134646OtherPTAN# INDIVIDUAL
TXTXB134646OtherPTAN# INDIVIDUAL
TXF40987Medicare UPIN