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General NPI Number Information
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NPI Number | 1982587580
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Entity Type | Organization
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Legal Business Name | TY ORTHO MANAGEMENT PLLC
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Dates
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Enumeration Date | 07/30/2025
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Last Update Date | 07/30/2025
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Provider Practice Location Address
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Address Line | 801 W PARK ROW DR
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City | ARLINGTON
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State | TX
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Zip | 76013-3904
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Country | US
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Telephone | 817-784-7888
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Fax |
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Provider Business Mailing Address
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Address Line | 8150 SPRINGWOOD DR # 150B
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City | IRVING
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State | TX
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Zip | 75063-5810
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Country | US
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Telephone | 956-507-7253
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Fax |
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | TIEN PHAN
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Credential | DMD
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Telephone | 408-835-3726
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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