Provider Demographics
NPI:1942685128
Name:BANH, PHUONG JULIA (FNP-C)
Entity Type:Individual
Prefix:
First Name:PHUONG JULIA
Middle Name:
Last Name:BANH
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MRS
Other - First Name:JULIA
Other - Middle Name:HOANG PHUONG
Other - Last Name:BANH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:119 SWEETGUM DR
Mailing Address - Street 2:
Mailing Address - City:MURPHY
Mailing Address - State:TX
Mailing Address - Zip Code:75094-3442
Mailing Address - Country:US
Mailing Address - Phone:214-909-5670
Mailing Address - Fax:
Practice Address - Street 1:3465 W WALNUT ST
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75042-7153
Practice Address - Country:US
Practice Address - Phone:972-272-7816
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-29
Last Update Date:2015-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP128559363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily