Healthcare Provider Details

I. General information

NPI: 1124500442
Provider Name (Legal Business Name): DEBBIE DUYEN HUYNH LSA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/04/2018
Last Update Date: 06/10/2022
Certification Date: 06/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1622 TARRYTOWN LN
ALLEN TX
75013-3345
US

IV. Provider business mailing address

5316 TUSCARORA TRL
MCKINNEY TX
75070-1611
US

V. Phone/Fax

Practice location:
  • Phone: 870-208-7542
  • Fax:
Mailing address:
  • Phone: 870-208-7542
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number183893
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License NumberSA00745
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: