MEDICARE: CUC HOANG CRNA

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	367500000X	Certified Registered Nurse Anesthetist	638585	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	89782U	OTHER	TX	BCBSTX
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1629040753
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CUC HOANG CRNA

Provider Business Mailing Address
First Line	:	500 THROCKMORTON ST
Second Line	:	#2002
City	:	FORT WORTH
State	:	TX
Zip	:	76102-3708
Country	:	US
Telephone Number	:	214-923-3508
Fax Number	:

Provider Business Practice Location Address
First Line	:	500 THROCKMORTON ST
Second Line	:	#2002
City	:	FORT WORTH
State	:	TX
Zip	:	76102-3708
Country	:	US
Telephone Number	:	214-923-3508
Fax Number	:

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

Provider Enumeration Date	:	02/02/2006
Last Update Date	:	06/28/2010

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Directions to “ CUC HOANG CRNA” Practice Location

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