Provider Demographics
NPI:1366549347
Name:FAIRFIELD FAMILY PHYSICIANS, PA
Entity type:Organization
Organization Name:FAIRFIELD FAMILY PHYSICIANS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TRUNG
Authorized Official - Middle Name:D
Authorized Official - Last Name:DINH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-373-0162
Mailing Address - Street 1:15201 MASON RD
Mailing Address - Street 2:#1200
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-5954
Mailing Address - Country:US
Mailing Address - Phone:281-373-0162
Mailing Address - Fax:281-373-0765
Practice Address - Street 1:15201 MASON RD
Practice Address - Street 2:#1200
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-5954
Practice Address - Country:US
Practice Address - Phone:281-373-0162
Practice Address - Fax:281-373-0765
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2008-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0003LEOtherBCBS
TX169777301Medicaid
TX169777301Medicaid