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NPI Code Detail

MEDICARE: QUYNH-PHUONG N NGO MD

MEDICARE: QUYNH-PHUONG N NGO MD
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
1208000000XPediatrics PhysicianS7518TX

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11M0608OTHERTXMEDICARE

General Provider Information

NPI Number : 1548794555
Entity Type Code : Individual
Provider Name (Legal Business Name) : QUYNH-PHUONG N NGO MD
Provider Business Mailing Address
First Line : PO BOX 733784
Second Line :
City : DALLAS
State : TX
Zip : 75373-3784
Country : US
Telephone Number : 682-885-6483
Fax Number : 682-885-3113
Provider Business Practice Location Address
First Line : 3131 S CENTER ST
Second Line :
City : ARLINGTON
State : TX
Zip : 76014-2007
Country : US
Telephone Number : 817-375-1413
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/17/2017
Last Update Date : 04/03/2024

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Directions to “ QUYNH-PHUONG N NGO MD” Practice Location

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