MEDICARE: KATHY HUA DDS

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	1223G0001X	General Practice Dentistry	37409	TX

General Provider Information

NPI Number	:	1275103723
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHY HUA DDS

Provider Business Mailing Address
First Line	:	8616 TRINITY VISTA TRL
Second Line	:
City	:	HURST
State	:	TX
Zip	:	76053-7518
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	398 E FM 1382 STE B
Second Line	:
City	:	CEDAR HILL
State	:	TX
Zip	:	75104-6056
Country	:	US
Telephone Number	:	972-291-6262
Fax Number	:

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

Provider Enumeration Date	:	06/28/2021
Last Update Date	:	06/28/2021

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