Healthcare Provider Details

I. General information

NPI: 1013625516
Provider Name (Legal Business Name): TARRANT PULMONARY ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2022
Last Update Date: 05/11/2023
Certification Date: 05/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 OMEGA DR STE 208
ARLINGTON TX
76014-2075
US

IV. Provider business mailing address

601 OMEGA DR STE 208
ARLINGTON TX
76014-2075
US

V. Phone/Fax

Practice location:
  • Phone: 682-323-7006
  • Fax: 888-720-1899
Mailing address:
  • Phone: 682-323-7006
  • Fax: 888-720-1899

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: PHAN NGUYEN
Title or Position: OWNER, MD
Credential: MD
Phone: 682-323-7006