Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | K5885 | TX |
N | 111NI0900X | Internist | K5885 | TX |
Y | 207RH0002X | Hospice and Palliative Medicine | K5885 | TX |
NPI | 1316967946 |
---|---|
Provider Name | Quan T Dang |
First Address | Dallas, TX 75391-1230 |
Second Address | Austin, TX 78701 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2006 |
Last Update Date | 13/08/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
044921702 | (05) | TX |
044921709 | (05) | TX |
044921710 | (05) | TX |
8D0487 | (02) | TX |
8R7682 | BLUE CROSS BLUE SHIELD (01) | TX |