Provider Demographics
NPI:1104535269
Name:DUONG, ANH
Entity type:Individual
Prefix:
First Name:ANH
Middle Name:
Last Name:DUONG
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12428 OCEAN SPRAY DR
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75036-0341
Mailing Address - Country:US
Mailing Address - Phone:210-975-0578
Mailing Address - Fax:
Practice Address - Street 1:2023 W MCDERMOTT DR STE 240
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-4679
Practice Address - Country:US
Practice Address - Phone:972-330-2696
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-17
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX174400000X
TX38720104246ZE0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic
No174400000XOther Service ProvidersSpecialist