Provider Demographics
NPI:1568403889
Name:DANG, HUNG T (MD)
Entity Type:Individual
Prefix:MR
First Name:HUNG
Middle Name:T
Last Name:DANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10838 BEECHNUT ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77072
Mailing Address - Country:US
Mailing Address - Phone:281-575-9967
Mailing Address - Fax:281-575-9883
Practice Address - Street 1:10838 BEECHNUT ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77072
Practice Address - Country:US
Practice Address - Phone:281-575-9967
Practice Address - Fax:281-575-9883
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-09
Last Update Date:2012-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ6397207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX092175101Medicaid
TXG35902Medicare UPIN
TX8A1932Medicare PIN