MEDICARE: TICH NGOC TRUONG MD PA

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
1	207Q00000X	Family Medicine Physician	G2867	TX
2	2081P2900X	Pain Medicine (Physical Medicine & Rehabilitation) Physician	G 2867	TX

General Provider Information

NPI Number	:	1851454722
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TICH NGOC TRUONG MD PA

Provider Business Mailing Address
First Line	:	6465 E MOCKINGBIRD LN
Second Line	:	SUITE 314
City	:	DALLAS
State	:	TX
Zip	:	75214-2454
Country	:	US
Telephone Number	:	214-826-8336
Fax Number	:	214-826-8836

Provider Business Practice Location Address
First Line	:	6465 E MOCKINGBIRD LN
Second Line	:	SUITE 314
City	:	DALLAS
State	:	TX
Zip	:	75214-2454
Country	:	US
Telephone Number	:	214-826-8336
Fax Number	:	214-826-8836

Authorized Official
Title or Position	:	OWNER
Name	:	DR. TICH NGOC TRUONG
Credential	:	M.D.,P.A.
Telephone Number	:	214-826-8336

Provider Enumeration Date	:	12/19/2006
Last Update Date	:	09/11/2025

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