Provider Demographics
NPI:1215576715
Name:HONG, BAOHIEP (CPHT)
Entity Type:Individual
Prefix:MR
First Name:BAOHIEP
Middle Name:
Last Name:HONG
Suffix:
Gender:M
Credentials:CPHT
Other - Prefix:MR
Other - First Name:HIEP
Other - Middle Name:
Other - Last Name:HONG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CPHT
Mailing Address - Street 1:2742 GRAND OAKS LOOP
Mailing Address - Street 2:
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-4381
Mailing Address - Country:US
Mailing Address - Phone:512-619-9448
Mailing Address - Fax:
Practice Address - Street 1:1812 CENTRE CREEK DR STE 115
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78754-5133
Practice Address - Country:US
Practice Address - Phone:512-579-0184
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-31
Last Update Date:2019-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174H00000X
TX216340183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician
No174H00000XOther Service ProvidersHealth Educator