Provider Demographics
NPI:1306882816
Name:DANG, QUYNH TRAN (MD)
Entity type:Individual
Prefix:
First Name:QUYNH
Middle Name:TRAN
Last Name:DANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 HOSPITAL DR STE 340
Mailing Address - Street 2:
Mailing Address - City:BOSSIER CITY
Mailing Address - State:LA
Mailing Address - Zip Code:71111-2157
Mailing Address - Country:US
Mailing Address - Phone:318-212-7883
Mailing Address - Fax:318-212-7885
Practice Address - Street 1:2300 HOSPITAL DR STE 340
Practice Address - Street 2:
Practice Address - City:BOSSIER CITY
Practice Address - State:LA
Practice Address - Zip Code:71111-2157
Practice Address - Country:US
Practice Address - Phone:318-212-7883
Practice Address - Fax:318-212-7885
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA12222R208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1699128Medicaid
TX144533001Medicaid