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NPI Code Detail

MEDICARE: TIEN M TRUONG D.O.

MEDICARE: TIEN M TRUONG D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianL3508TX

General Provider Information

NPI Number : 1356344600
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIEN M TRUONG D.O.
Provider Business Mailing Address
First Line : 2415 MATLOCK RD
Second Line :
City : ARLINGTON
State : TX
Zip : 76015-1619
Country : US
Telephone Number : 817-277-6444
Fax Number : 817-548-7329
Provider Business Practice Location Address
First Line : 2415 MATLOCK RD
Second Line :
City : ARLINGTON
State : TX
Zip : 76015-1619
Country : US
Telephone Number : 817-277-6444
Fax Number : 817-548-7329
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2005
Last Update Date : 09/11/2012

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Directions to “ TIEN M TRUONG D.O.” Practice Location

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