Provider Demographics
NPI:1386825701
Name:HUYNH, DAI KHANH
Entity Type:Individual
Prefix:
First Name:DAI
Middle Name:KHANH
Last Name:HUYNH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12211 SPRING GROVE DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77099-3109
Mailing Address - Country:US
Mailing Address - Phone:713-894-8015
Mailing Address - Fax:
Practice Address - Street 1:12211 SPRING GROVE DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77099-3109
Practice Address - Country:US
Practice Address - Phone:713-894-8015
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-14
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies