Provider Demographics
NPI:1346274099
Name:DANG, DZUNG DUC (DPM)
Entity Type:Individual
Prefix:DR
First Name:DZUNG
Middle Name:DUC
Last Name:DANG
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 SANTA FE ST
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78404-2338
Mailing Address - Country:US
Mailing Address - Phone:361-884-9900
Mailing Address - Fax:361-884-9903
Practice Address - Street 1:1215 SANTA FE ST
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78404-2338
Practice Address - Country:US
Practice Address - Phone:361-884-9900
Practice Address - Fax:361-884-9903
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1173213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX092799803Medicaid
U26439Medicare UPIN
TX092799802Medicaid