Provider Demographics
NPI:1336122829
Name:DO, NGOC-DIEP T (MPA-C)
Entity Type:Individual
Prefix:MS
First Name:NGOC-DIEP
Middle Name:T
Last Name:DO
Suffix:
Gender:F
Credentials:MPA-C
Other - Prefix:
Other - First Name:CATARINA
Other - Middle Name:
Other - Last Name:DO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:11525 N MERIDIAN AVE APT 222
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-8041
Mailing Address - Country:US
Mailing Address - Phone:210-902-6949
Mailing Address - Fax:210-614-8740
Practice Address - Street 1:1365 CLIFTON RD NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322-3832
Practice Address - Country:US
Practice Address - Phone:404-778-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-29
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA03695363AM0700X
GA10326207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical