Healthcare Provider Details

I. General information

NPI: 1356577282
Provider Name (Legal Business Name): HUNG HOANG TRUONG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2009
Last Update Date: 08/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 W AIRPORT FWY STE 143
IRVING TX
75062
US

IV. Provider business mailing address

122 W JOHN CARPENTER FWY STE 420
IRVING TX
75039-2014
US

V. Phone/Fax

Practice location:
  • Phone: 469-488-4500
  • Fax: 469-488-4501
Mailing address:
  • Phone: 972-957-3000
  • Fax: 972-957-3005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberP3261
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: