Provider Demographics
NPI:1407670854
Name:DANG, ANNY LOAN
Entity type:Individual
Prefix:
First Name:ANNY
Middle Name:LOAN
Last Name:DANG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2534 CRESTEDGE DR
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75044-7042
Mailing Address - Country:US
Mailing Address - Phone:469-434-7516
Mailing Address - Fax:
Practice Address - Street 1:2534 CRESTEDGE DR
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75044-7042
Practice Address - Country:US
Practice Address - Phone:469-434-7516
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-12
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant