Provider Demographics
NPI:1922732817
Name:ARIA MEDICAL, PLLC
Entity Type:Organization
Organization Name:ARIA MEDICAL, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAM
Authorized Official - Middle Name:NHAT
Authorized Official - Last Name:CUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-701-0199
Mailing Address - Street 1:1402 S CUSTER RD STE 401
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75072-1452
Mailing Address - Country:US
Mailing Address - Phone:469-714-0057
Mailing Address - Fax:
Practice Address - Street 1:12200 PARK CENTRAL DR STE 110
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75251-2125
Practice Address - Country:US
Practice Address - Phone:469-714-0057
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-15
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX360740002Medicaid