Provider Demographics
NPI:1508883091
Name:HOANG, TUYEN THI (DPM)
Entity Type:Individual
Prefix:DR
First Name:TUYEN
Middle Name:THI
Last Name:HOANG
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 462466
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75046-2466
Mailing Address - Country:US
Mailing Address - Phone:972-441-2070
Mailing Address - Fax:972-455-8061
Practice Address - Street 1:2522 DENMARK DR
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75040-4309
Practice Address - Country:US
Practice Address - Phone:972-441-2070
Practice Address - Fax:972-455-8061
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2021-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1914213EP1101X, 213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX212805001Medicaid
LA1537497Medicaid
LAU69871Medicare UPIN
LA5744750001Medicare NSC
LA5A312Medicare PIN
LA1537497Medicaid