MEDICARE: LAM Q HOANG DDS, MS

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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	20631	TX

General Provider Information

NPI Number	:	1225147242
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAM Q HOANG DDS, MS

Provider Business Mailing Address
First Line	:	11811 FM 1960 RD W
Second Line	:	SUITE 150
City	:	HOUSTON
State	:	TX
Zip	:	77065-3827
Country	:	US
Telephone Number	:	281-955-0380
Fax Number	:	281-955-0392

Provider Business Practice Location Address
First Line	:	11811 FM 1960 RD W
Second Line	:	SUITE 150
City	:	HOUSTON
State	:	TX
Zip	:	77065-3827
Country	:	US
Telephone Number	:	281-955-0380
Fax Number	:	281-955-0392

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

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	07/09/2007

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