Healthcare Provider Details

I. General information

NPI: 1245434661
Provider Name (Legal Business Name): STONEBRIAR PEDIATRICS, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3550 PARKWOOD BLVD SUITE C-306
FRISCO TX
75034-1903
US

IV. Provider business mailing address

3550 PARKWOOD BLVD SUITE C-306
FRISCO TX
75034-1903
US

V. Phone/Fax

Practice location:
  • Phone: 972-668-7110
  • Fax: 972-668-7135
Mailing address:
  • Phone: 972-668-7110
  • Fax: 972-668-7135

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberL2322
License Number StateTX

VIII. Authorized Official

Name: DR. THAI VINH HOANG
Title or Position: PRESIDENT
Credential: M.D.
Phone: 972-668-7110