Provider Demographics
NPI:1295716181
Name:HOANG, DAVID NGA (DO)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:NGA
Last Name:HOANG
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2324 VAQUERO LN
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75010-4977
Mailing Address - Country:US
Mailing Address - Phone:214-702-2353
Mailing Address - Fax:800-715-3378
Practice Address - Street 1:6821 COLUMBINE WAY
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-6345
Practice Address - Country:US
Practice Address - Phone:800-715-3378
Practice Address - Fax:800-715-3378
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-08
Last Update Date:2020-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL8731207Q00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX166667911Medicaid
TXP01119929OtherRAILROAD MCARE
TXTXB125692Medicare PIN
TXP01119929OtherRAILROAD MCARE
TX4F477Medicare ID - Type Unspecified