Provider Demographics
NPI:1063783827
Name:THANH K. HOANG, M.D., P.A, DBA HORIZON HEALTHCARE CLINIC
Entity type:Organization
Organization Name:THANH K. HOANG, M.D., P.A, DBA HORIZON HEALTHCARE CLINIC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THANH
Authorized Official - Middle Name:KIM
Authorized Official - Last Name:HOANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:832-326-3096
Mailing Address - Street 1:11210 BELLAIRE BLVD
Mailing Address - Street 2:126A
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77072-2528
Mailing Address - Country:US
Mailing Address - Phone:281-564-2900
Mailing Address - Fax:281-564-0800
Practice Address - Street 1:11210 BELLAIRE BLVD STE 126A
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77072-2528
Practice Address - Country:US
Practice Address - Phone:281-564-2900
Practice Address - Fax:281-564-0800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-25
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ9885207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
45D1058181OtherCLIA WAIVED CERTIFICATE
TX01808303Medicaid
TX113793704Medicaid
TX018083802Medicaid
TX113793701Medicaid