Provider Demographics
NPI:1720185671
Name:NGO, TIM TINH (DC)
Entity Type:Individual
Prefix:DR
First Name:TIM
Middle Name:TINH
Last Name:NGO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 180932
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76096-0932
Mailing Address - Country:US
Mailing Address - Phone:972-693-3135
Mailing Address - Fax:
Practice Address - Street 1:2505 E ARKANSAS LN
Practice Address - Street 2:SUITE 143
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76010-0212
Practice Address - Country:US
Practice Address - Phone:972-693-3135
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2009-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8625111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX721525428OtherTAX ID