Provider Demographics
NPI:1316023856
Name:HA, MINH (PT)
Entity Type:Individual
Prefix:
First Name:MINH
Middle Name:
Last Name:HA
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5032 SHOWDOWN LN
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052-2436
Mailing Address - Country:US
Mailing Address - Phone:501-920-4226
Mailing Address - Fax:
Practice Address - Street 1:911 N MOROCCO AVE
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75211-1249
Practice Address - Country:US
Practice Address - Phone:972-794-4569
Practice Address - Fax:972-794-4573
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2009-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2403225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist