Provider Demographics
NPI:1376541656
Name:DANG, HUNG T (MD)
Entity Type:Individual
Prefix:DR
First Name:HUNG
Middle Name:T
Last Name:DANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3020 MATLOCK RD
Mailing Address - Street 2:#200
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76015-2901
Mailing Address - Country:US
Mailing Address - Phone:817-468-5252
Mailing Address - Fax:817-468-5257
Practice Address - Street 1:3020 MATLOCK RD
Practice Address - Street 2:#200
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76015-2901
Practice Address - Country:US
Practice Address - Phone:817-468-5252
Practice Address - Fax:817-468-5257
Is Sole Proprietor?:No
Enumeration Date:2005-07-12
Last Update Date:2007-11-08
Deactivation Date:2006-03-16
Deactivation Code:
Reactivation Date:2006-03-22
Provider Licenses
StateLicense IDTaxonomies
TXK5500207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8C9898Medicare PIN