MEDICARE: TAM NHAT CUNG DO

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	207Q00000X	Family Medicine Physician	Q5993	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194012161
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAM NHAT CUNG DO

Provider Business Mailing Address
First Line	:	1402 S CUSTER RD STE 401
Second Line	:
City	:	MCKINNEY
State	:	TX
Zip	:	75072-1452
Country	:	US
Telephone Number	:	469-714-0057
Fax Number	:	469-757-2388

Provider Business Practice Location Address
First Line	:	1402 S CUSTER RD STE 401
Second Line	:
City	:	MCKINNEY
State	:	TX
Zip	:	75072-1452
Country	:	US
Telephone Number	:	469-714-0057
Fax Number	:

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

Provider Enumeration Date	:	06/29/2011
Last Update Date	:	05/28/2024

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Directions to “ TAM NHAT CUNG DO” Practice Location

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