=====================================================
General NPI Number Information
=====================================================
NPI Number | 1689883761
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | HUE TANG MD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/22/2007
-----------------------------------------------------
Last Update Date | 10/25/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2225 PEGGY LN
-----------------------------------------------------
City | GARLAND
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75042-5708
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-272-8525
-----------------------------------------------------
Fax | 972-487-6481
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2225 PEGGY LN
-----------------------------------------------------
City | GARLAND
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75042-5708
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-272-8525
-----------------------------------------------------
Fax | 972-487-6481
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207V00000X
-----------------------------------------------------
Taxonomy Name | Obstetrics & Gynecology Physician
-----------------------------------------------------
License Number | N4146
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------