Provider Demographics
NPI:1568636819
Name:HUY NGUYEN KHOA PLLC
Entity Type:Organization
Organization Name:HUY NGUYEN KHOA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HUY
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUYEN KHOA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-200-5536
Mailing Address - Street 1:1225 E. BELT LINE RD
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75081
Mailing Address - Country:US
Mailing Address - Phone:972-200-5536
Mailing Address - Fax:972-200-5668
Practice Address - Street 1:1225 E. BELT LINE RD
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75081
Practice Address - Country:US
Practice Address - Phone:972-200-5536
Practice Address - Fax:972-200-5668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-17
Last Update Date:2020-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDP1476213E00000X
213E00000X
TXTX 1476213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU75885Medicare UPIN
TX5399740001Medicare NSC
00592EMedicare PIN