Provider Demographics
NPI:1720223449
Name:HOANG, LAN T (MD)
Entity Type:Individual
Prefix:
First Name:LAN
Middle Name:T
Last Name:HOANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1600 W 38TH ST
Mailing Address - Street 2:SUITE 320
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-6400
Mailing Address - Country:US
Mailing Address - Phone:512-324-3310
Mailing Address - Fax:512-324-3311
Practice Address - Street 1:11111 RESEARCH BLVD
Practice Address - Street 2:SUITE 220
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-5264
Practice Address - Country:US
Practice Address - Phone:512-324-6755
Practice Address - Fax:512-324-6753
Is Sole Proprietor?:No
Enumeration Date:2008-12-09
Last Update Date:2013-11-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ORLL17980207W00000X
TXP5188207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX320208701Medicaid
TX320208702Medicaid
TX320208702Medicaid