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NPI Code Detail

MEDICARE: HOANG DINH PA

MEDICARE: HOANG DINH PA
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
1363A00000XPhysician AssistantMA053061PA
2363A00000XPhysician AssistantPA07813TX

General Provider Information

NPI Number : 1235325382
Entity Type Code : Individual
Provider Name (Legal Business Name) : HOANG DINH PA
Provider Business Mailing Address
First Line : 5601 AMERADA CIR
Second Line : APT 825
City : ARLINGTON
State : TX
Zip : 76017-0564
Country : US
Telephone Number : 817-313-5275
Fax Number :
Provider Business Practice Location Address
First Line : 601 W TERRELL AVE
Second Line :
City : FORT WORTH
State : TX
Zip : 76104-3243
Country : US
Telephone Number : 817-313-5275
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2007
Last Update Date : 12/06/2012

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Directions to “ HOANG DINH PA” Practice Location

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