MEDICARE: MISS HANH THI DINH PA-C

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	363A00000X	Physician Assistant	PA11943	TX

General Provider Information

NPI Number	:	1447736475
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS HANH THI DINH PA-C

Provider Business Mailing Address
First Line	:	5308 N TARRANT PKWY
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76244-6293
Country	:	US
Telephone Number	:	817-993-6889
Fax Number	:	833-317-1682

Provider Business Practice Location Address
First Line	:	5308 N TARRANT PKWY
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76244-6293
Country	:	US
Telephone Number	:	817-993-6889
Fax Number	:	833-317-1682

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

Provider Enumeration Date	:	07/12/2018
Last Update Date	:	09/29/2023

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