Provider Demographics
NPI:1184898207
Name:HEALING COMPANION MEDICAL CLINIC, PLLC
Entity type:Organization
Organization Name:HEALING COMPANION MEDICAL CLINIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NHU
Authorized Official - Middle Name:QUYNH
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:214-676-3166
Mailing Address - Street 1:3110 LAMESA DR
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75041-4201
Mailing Address - Country:US
Mailing Address - Phone:214-676-3166
Mailing Address - Fax:214-703-0808
Practice Address - Street 1:3110 LAMESA DR
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75041
Practice Address - Country:US
Practice Address - Phone:972-675-3818
Practice Address - Fax:214-703-0808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-18
Last Update Date:2019-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM2844207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0093RDOtherBLUE CROSS BLUE SHIELD
I59718Medicare UPIN
TX0093RDOtherBLUE CROSS BLUE SHIELD