Provider Demographics
NPI:1669481834
Name:PIONEER FAMILY DOCTOR ASSOCIATION
Entity Type:Organization
Organization Name:PIONEER FAMILY DOCTOR ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:HSIEN-HUI
Authorized Official - Middle Name:GRACE
Authorized Official - Last Name:HUANG
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:972-647-8282
Mailing Address - Street 1:817 W PIONEER PKWY STE 190
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75051-4724
Mailing Address - Country:US
Mailing Address - Phone:972-647-8282
Mailing Address - Fax:972-606-0202
Practice Address - Street 1:817 W PIONEER PKWY STE 190
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75051-4724
Practice Address - Country:US
Practice Address - Phone:972-647-8282
Practice Address - Fax:972-606-0202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-06
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX351261801Medicaid
=========OtherEIN
TXG89769Medicare UPIN