Provider Demographics
NPI:1639683576
Name:DO, HONG (FNP-BC)
Entity Type:Individual
Prefix:
First Name:HONG
Middle Name:
Last Name:DO
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 SW JOHNSON AVE STE C
Mailing Address - Street 2:
Mailing Address - City:BURLESON
Mailing Address - State:TX
Mailing Address - Zip Code:76028-5834
Mailing Address - Country:US
Mailing Address - Phone:817-766-7421
Mailing Address - Fax:
Practice Address - Street 1:621 SW JOHNSON AVE STE C
Practice Address - Street 2:
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76028-5834
Practice Address - Country:US
Practice Address - Phone:817-766-7421
Practice Address - Fax:817-447-8100
Is Sole Proprietor?:No
Enumeration Date:2017-11-30
Last Update Date:2017-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP136011363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily