Provider Demographics
NPI:1962958199
Name:HUYNH, TRANG
Entity type:Individual
Prefix:
First Name:TRANG
Middle Name:
Last Name:HUYNH
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 1:20389 INTERSTATE 35 FRONTAGE ROAD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:KYLE
Mailing Address - State:TX
Mailing Address - Zip Code:78640
Mailing Address - Country:US
Mailing Address - Phone:512-256-0327
Mailing Address - Fax:
Practice Address - Street 1:20389 INTERSTATE 35 FRONTAGE ROAD
Practice Address - Street 2:SUITE 200
Practice Address - City:KYLE
Practice Address - State:TX
Practice Address - Zip Code:78640
Practice Address - Country:US
Practice Address - Phone:512-256-0327
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-28
Last Update Date:2016-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32143122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist