Provider Demographics
NPI:1366479883
Name:DUONG, HIEN XUAN (DO)
Entity Type:Individual
Prefix:DR
First Name:HIEN
Middle Name:XUAN
Last Name:DUONG
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8621 COBBLESTONE
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78735-7907
Mailing Address - Country:US
Mailing Address - Phone:512-809-8667
Mailing Address - Fax:
Practice Address - Street 1:901 W BEN WHITE BLVD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704
Practice Address - Country:US
Practice Address - Phone:512-447-2211
Practice Address - Fax:512-448-7326
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2007-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL2869207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX150875601Medicaid
TX150875601Medicaid
H59457Medicare UPIN