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NPI Code Detail

MEDICARE: TRA-MY NU DINH P.A.

MEDICARE: TRA-MY NU DINH P.A.
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
1363A00000XPhysician AssistantPA06035TX

General Provider Information

NPI Number : 1720211717
Entity Type Code : Individual
Provider Name (Legal Business Name) : TRA-MY NU DINH P.A.
Provider Business Mailing Address
First Line : 3201 W SANER AVE
Second Line :
City : DALLAS
State : TX
Zip : 75233-1430
Country : US
Telephone Number : 214-331-0567
Fax Number : 214-377-7779
Provider Business Practice Location Address
First Line : 3201 W SANER AVE
Second Line :
City : DALLAS
State : TX
Zip : 75233-1430
Country : US
Telephone Number : 214-331-0567
Fax Number : 214-377-7779
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/25/2009
Last Update Date : 08/25/2009

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Directions to “ TRA-MY NU DINH P.A.” Practice Location

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