Basic Information
Provider Information
NPI: 1528407772
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HUYNH
FirstName: MYLIEN
MiddleName: T
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 205 E TORONTO AVE
Address2:  
City: MCALLEN
State: TX
PostalCode: 785031209
CountryCode: US
TelephoneNumber: 9566876155
FaxNumber: 9566180451
Practice Location
Address1: 205 E TORONTO AVE
Address2:  
City: MCALLEN
State: TX
PostalCode: 78503
CountryCode: US
TelephoneNumber: 9566876155
FaxNumber: 9566180451
Other Information
ProviderEnumerationDate: 06/20/2013
LastUpdateDate: 09/04/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000XQ7208TXY Allopathic & Osteopathic PhysiciansEmergency Medicine 
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 

No ID Information.


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