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General NPI Number Information
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NPI Number | 1174762611
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Entity Type | Individual
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Provider Name | TRANG TRUONG NGUYEN PAC
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Gender | Female
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Dates
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Enumeration Date | 02/06/2009
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Last Update Date | 11/03/2023
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Provider Practice Location Address
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Address Line | 5303 HARRY HINES BLVD
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City | DALLAS
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State | TX
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Zip | 75390-9255
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Country | US
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Telephone | 241-645-2800
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 845347
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City | DALLAS
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State | TX
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Zip | 75284-7208
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Country | US
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Telephone | 214-645-2800
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Fax | 214-645-8697
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA06070
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License Number State | TX
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