Provider Demographics
NPI:1962019075
Name:HOANG, MY-LINH
Entity Type:Individual
Prefix:
First Name:MY-LINH
Middle Name:
Last Name:HOANG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 STONEHURST DR
Mailing Address - Street 2:
Mailing Address - City:YOUNGSVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70592-5770
Mailing Address - Country:US
Mailing Address - Phone:504-931-1233
Mailing Address - Fax:
Practice Address - Street 1:123 SAINT NAZAIRE RD
Practice Address - Street 2:
Practice Address - City:BROUSSARD
Practice Address - State:LA
Practice Address - Zip Code:70518-4202
Practice Address - Country:US
Practice Address - Phone:337-837-8886
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-23
Last Update Date:2020-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPST.023525183500000X
LA023525183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist