Provider Demographics
NPI:1326281445
Name:HOANG, QUOC TRAN (PA-C)
Entity Type:Individual
Prefix:
First Name:QUOC
Middle Name:TRAN
Last Name:HOANG
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:100 MEDICAL CENTER BLVD STE 118
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304-2821
Mailing Address - Country:US
Mailing Address - Phone:936-539-4031
Mailing Address - Fax:936-539-4537
Practice Address - Street 1:100 MEDICAL CENTER BLVD STE 118
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-2821
Practice Address - Country:US
Practice Address - Phone:936-539-4031
Practice Address - Fax:936-539-4537
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-20
Last Update Date:2009-04-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXPA06157363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant