Provider Demographics
NPI:1417942632
Name:HUANG, DANIEL (PA-C)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:
Last Name:HUANG
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:660 CHIPPENHAM DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-5611
Mailing Address - Country:US
Mailing Address - Phone:713-305-3065
Mailing Address - Fax:
Practice Address - Street 1:7777 HENNESSY BLVD
Practice Address - Street 2:SUITE 1008
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-4300
Practice Address - Country:US
Practice Address - Phone:225-766-0416
Practice Address - Fax:225-769-9212
Is Sole Proprietor?:No
Enumeration Date:2005-09-14
Last Update Date:2015-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA03213363AS0400X
LAPA.A10296363AS0400X
CO3939363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXS48148Medicare UPIN
TX86N965Medicare PIN