Provider Demographics
NPI:1689874190
Name:PHUNG, TRI MINH (MD)
Entity Type:Individual
Prefix:
First Name:TRI
Middle Name:MINH
Last Name:PHUNG
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 1:5323 HARRY HINES BLVD
Mailing Address - Street 2:DEPARTMENT OF ANESTHESIOLOGY AND PAIN MANAGEMENT
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75390-9068
Mailing Address - Country:US
Mailing Address - Phone:214-648-5460
Mailing Address - Fax:
Practice Address - Street 1:5323 HARRY HINES BLVD
Practice Address - Street 2:DEPARTMENT OF ANESTHESIOLOGY AND PAIN MANAGEMENT
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75390-9068
Practice Address - Country:US
Practice Address - Phone:214-648-5460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-23
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN8443207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology