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NPI Code Detail

MEDICARE: PHUNG DINH

MEDICARE: PHUNG DINH
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
1363LF0000XFamily Nurse PractitionerAP141762TX

General Provider Information

NPI Number : 1619588936
Entity Type Code : Individual
Provider Name (Legal Business Name) : PHUNG DINH
Provider Business Mailing Address
First Line : 615 WHITETAIL RD
Second Line :
City : EULESS
State : TX
Zip : 76039-1110
Country : US
Telephone Number : 972-804-8598
Fax Number :
Provider Business Practice Location Address
First Line : 925 WRIGHT ST
Second Line :
City : ARLINGTON
State : TX
Zip : 76012-4731
Country : US
Telephone Number : 817-801-5704
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/11/2020
Last Update Date : 12/15/2025

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Directions to “ PHUNG DINH ” Practice Location

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