MEDICARE: MAI V HOANG MD

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	207Q00000X	Family Medicine Physician	K7766	TX

General Provider Information

NPI Number	:	1801982335
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAI V HOANG MD

Provider Business Mailing Address
First Line	:	4045 E BELKNAP ST STE 12
Second Line	:
City	:	HALTOM CITY
State	:	TX
Zip	:	76111-6637
Country	:	US
Telephone Number	:	817-759-2315
Fax Number	:	817-759-2316

Provider Business Practice Location Address
First Line	:	4045 E BELKNAP ST
Second Line	:	#12
City	:	HALTOM CITY
State	:	TX
Zip	:	76111-6638
Country	:	US
Telephone Number	:	817-759-2315
Fax Number	:	817-759-2316

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

Provider Enumeration Date	:	10/04/2006
Last Update Date	:	02/24/2021

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