Provider Demographics
NPI:1699959346
Name:HOANG, VIVIAN (MD)
Entity type:Individual
Prefix:DR
First Name:VIVIAN
Middle Name:
Last Name:HOANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:336 22ND AVE N
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1844
Mailing Address - Country:US
Mailing Address - Phone:615-346-8182
Mailing Address - Fax:615-823-8948
Practice Address - Street 1:6154 BELMONT AVE
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75214-3622
Practice Address - Country:US
Practice Address - Phone:615-346-8182
Practice Address - Fax:615-829-8970
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-18
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ546822084N0400X
OH1234522084N0400X
MDD774502084N0400X
TN507142084N0400X
IAMD-415962084N0400X
IN01074550A2084N0400X
IL0361343052084N0400X
GA0713662084N0400X
FLME1184842084N0400X
ALSP.932084N0400X
NMTM2013-08722084N0400X
CAA1152492084N0400X
NH165142084N0400X
SCMD371542084N0400X
TXP82512084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1699959346Medicaid
CAGE292ZMedicare PIN