Provider Demographics
NPI:1376570671
Name:HA, HIEU (PA)
Entity Type:Individual
Prefix:
First Name:HIEU
Middle Name:
Last Name:HA
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1517 THOMPSON RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469-4932
Mailing Address - Country:US
Mailing Address - Phone:281-344-1715
Mailing Address - Fax:281-344-1716
Practice Address - Street 1:1517 THOMPSON RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77469-4932
Practice Address - Country:US
Practice Address - Phone:281-344-1715
Practice Address - Fax:281-344-1716
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2008-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA03487363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8N8790OtherBLUE CROSS BLUE SHIELD
TXP00470292OtherRAILROAD MEDICARE
TX8L3355OtherMEDICARE-RBJC
TXP00470292OtherRAILROAD MEDICARE