MEDICARE: DR. DENNIS PHUONG DOAN MD

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	207RC0000X	Cardiovascular Disease Physician	N9041	TX

General Provider Information

NPI Number	:	1366776502
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DENNIS PHUONG DOAN MD

Provider Business Mailing Address
First Line	:	7520 N BEACH ST STE 108
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76137-1507
Country	:	US
Telephone Number	:	469-580-6137
Fax Number	:	817-213-6998

Provider Business Practice Location Address
First Line	:	7520 N BEACH ST STE 108
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76137-1507
Country	:	US
Telephone Number	:	469-580-6137
Fax Number	:	817-213-6998

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

Provider Enumeration Date	:	09/21/2009
Last Update Date	:	11/05/2025

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