Provider Demographics
NPI:1851147185
Name:KHUONG, MATTHEW (CAA)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:KHUONG
Suffix:
Gender:M
Credentials:CAA
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Mailing Address - Street 1:228 MANZANITA DR
Mailing Address - Street 2:
Mailing Address - City:MUSTANG RIDGE
Mailing Address - State:TX
Mailing Address - Zip Code:78610-2594
Mailing Address - Country:US
Mailing Address - Phone:512-739-5120
Mailing Address - Fax:
Practice Address - Street 1:2400 ROUND ROCK AVE
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-4004
Practice Address - Country:US
Practice Address - Phone:512-341-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-26
Last Update Date:2024-05-07
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist Assistant