Provider Demographics
NPI:1457317125
Name:TSENG, ALEX YUNG-NAM (DO)
Entity Type:Individual
Prefix:DR
First Name:ALEX
Middle Name:YUNG-NAM
Last Name:TSENG
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 1:106 HERITAGE PL
Mailing Address - Street 2:
Mailing Address - City:GLEN ROSE
Mailing Address - State:TX
Mailing Address - Zip Code:76043-5326
Mailing Address - Country:US
Mailing Address - Phone:817-691-6698
Mailing Address - Fax:
Practice Address - Street 1:106 HERITAGE PL
Practice Address - Street 2:
Practice Address - City:GLEN ROSE
Practice Address - State:TX
Practice Address - Zip Code:76043-5326
Practice Address - Country:US
Practice Address - Phone:817-691-6698
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2016-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ9403207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
G08863Medicare UPIN