Basic Information
| Provider Information | |||||||||
| NPI: | 1356577282 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TRUONG | ||||||||
| FirstName: | HUNG | ||||||||
| MiddleName: | HOANG | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 122 W JOHN CARPENTER FWY STE 420 | ||||||||
| Address2: | |||||||||
| City: | IRVING | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750392014 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9729573000 | ||||||||
| FaxNumber: | 9729573005 | ||||||||
| Practice Location | |||||||||
| Address1: | 1111 W AIRPORT FWY STE 143 | ||||||||
| Address2: | |||||||||
| City: | IRVING | ||||||||
| State: | TX | ||||||||
| PostalCode: | 75062 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4694884500 | ||||||||
| FaxNumber: | 4694884501 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/05/2009 | ||||||||
| LastUpdateDate: | 08/21/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | P3261 | TX | Y | Allopathic & Osteopathic Physicians | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | BP10034712 | 01 | TX | LICENSE | OTHER | P3261 | 01 | TX | PROFESSIONAL LICENSE | OTHER |