Provider Demographics
NPI:1912960378
Name:HOANG, PHAT TUAN (DC)
Entity Type:Individual
Prefix:DR
First Name:PHAT
Middle Name:TUAN
Last Name:HOANG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3205 W DAVIS ST
Mailing Address - Street 2:SUITE B100
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304-2039
Mailing Address - Country:US
Mailing Address - Phone:936-494-2010
Mailing Address - Fax:936-494-2012
Practice Address - Street 1:3205 W DAVIS ST
Practice Address - Street 2:SUITE B100
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-2039
Practice Address - Country:US
Practice Address - Phone:936-494-2010
Practice Address - Fax:936-494-2012
Is Sole Proprietor?:No
Enumeration Date:2006-04-07
Last Update Date:2022-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9800111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX5676594OtherFIRST HEALTH
TX7462734OtherAETNA
TX8R8142OtherBCBS
TX????OtherPACIFICARE
TX8R8142OtherBCBS