MEDICARE: DR. CHUONG DUONG D.O.

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	207P00000X	Emergency Medicine Physician	N6270	TX
2	207Q00000X	Family Medicine Physician	OT011880	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1780842146
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHUONG DUONG D.O.

Provider Business Mailing Address
First Line	:	PO BOX 171501
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75017-1501
Country	:	US
Telephone Number	:	972-696-9775
Fax Number	:

Provider Business Practice Location Address
First Line	:	3321 S COOPER ST
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76015-2345
Country	:	US
Telephone Number	:	972-696-9775
Fax Number	:

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

Provider Enumeration Date	:	06/01/2008
Last Update Date	:	04/25/2017

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Directions to “ DR. CHUONG DUONG D.O.” Practice Location

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