MEDICARE: SANDY HONG PMHNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	2021028836	MO
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	1196827	TX

General Provider Information

NPI Number	:	1114590478
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANDY HONG PMHNP-BC

Provider Business Mailing Address
First Line	:	4120 SANDHILLS LN
Second Line	:
City	:	PROSPER
State	:	TX
Zip	:	75078-0989
Country	:	US
Telephone Number	:	417-387-3857
Fax Number	:

Provider Business Practice Location Address
First Line	:	2601 LITTLE ELM PKWY STE 2503
Second Line	:
City	:	LITTLE ELM
State	:	TX
Zip	:	75068-6706
Country	:	US
Telephone Number	:	516-710-2906
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/22/2021
Last Update Date	:	05/29/2026

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