Provider Demographics
NPI:1720385909
Name:TRINH, KIEUNGA HOANG (MPT)
Entity Type:Individual
Prefix:MRS
First Name:KIEUNGA
Middle Name:HOANG
Last Name:TRINH
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4509 BRITTANY DR
Mailing Address - Street 2:
Mailing Address - City:ROWLETT
Mailing Address - State:TX
Mailing Address - Zip Code:75088-6709
Mailing Address - Country:US
Mailing Address - Phone:972-412-2649
Mailing Address - Fax:
Practice Address - Street 1:4509 BRITTANY DR
Practice Address - Street 2:
Practice Address - City:ROWLETT
Practice Address - State:TX
Practice Address - Zip Code:75088-6709
Practice Address - Country:US
Practice Address - Phone:972-412-2649
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-23
Last Update Date:2011-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1128528225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist