Provider Demographics
NPI:1063421238
Name:HUANG, HSIEN-HUI GRACE (DO)
Entity type:Individual
Prefix:DR
First Name:HSIEN-HUI
Middle Name:GRACE
Last Name:HUANG
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:817 W PIONEER PKWY STE 190
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75051-4724
Mailing Address - Country:US
Mailing Address - Phone:972-647-8282
Mailing Address - Fax:972-606-0202
Practice Address - Street 1:817 W PIONEER PKWY STE 190
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75051-4724
Practice Address - Country:US
Practice Address - Phone:972-647-8282
Practice Address - Fax:972-606-0202
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-06
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK3754207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX092336903Medicaid
BH5476204OtherDEA
TXG89769Medicare UPIN