Healthcare Provider Details

I. General information

NPI: 1083689194
Provider Name (Legal Business Name): ALFRED C HUANG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/22/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 N MACARTHUR BLVD IRVING
IRVING TX
75061-7413
US

IV. Provider business mailing address

117 N MACARTHUR BLVD IRVING
IRVING TX
75061-7413
US

V. Phone/Fax

Practice location:
  • Phone: 972-254-4447
  • Fax: 972-254-2629
Mailing address:
  • Phone: 972-254-4447
  • Fax: 972-254-2629

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberK4708
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: