Provider Demographics
NPI:1639238769
Name:NGUYEN, HANH DUNG THI (DO)
Entity Type:Individual
Prefix:
First Name:HANH DUNG
Middle Name:THI
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14860 MONTFORT DR
Mailing Address - Street 2:SUITE 140, LB 32
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75254-6718
Mailing Address - Country:US
Mailing Address - Phone:214-341-5630
Mailing Address - Fax:214-341-5689
Practice Address - Street 1:8420 ABRAMS RD STE 208
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-7582
Practice Address - Country:US
Practice Address - Phone:214-341-5630
Practice Address - Fax:214-341-5689
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS8021207Q00000X
TXL0454207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8A3633Medicare PIN
TX8F2303Medicare PIN
H63628Medicare UPIN