Provider Demographics
NPI:1982630836
Name:HOANG, HUONG T (PAC)
Entity Type:Individual
Prefix:
First Name:HUONG
Middle Name:T
Last Name:HOANG
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:499 E HAMPDEN AVE
Mailing Address - Street 2:SUITE 220
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-2780
Mailing Address - Country:US
Mailing Address - Phone:303-783-8844
Mailing Address - Fax:303-783-2002
Practice Address - Street 1:499 E HAMPDEN AVE
Practice Address - Street 2:SUITE 220
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-2780
Practice Address - Country:US
Practice Address - Phone:303-783-8844
Practice Address - Fax:303-783-2002
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2011-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1596363AM0700X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
P96543Medicare UPIN