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Organization
KHUONG PHAN, D.O., P.A.
Active
Organization
KHUONG PHAN, D.O., P.A.
Active
Other names
Mansfield Medical Associates
Organization subpart
No
Provider details
NPI number
Authorized official
KHUONG PHAN D.O. (OWNER)
(817) 473-7197
Entity
Organization
Contact information
Practice address
920 HIGHWAY 287 N, SUITE 308, MANSFIELD, TX 76063-2627
(817) 473-7197
(817) 473-7197
Mailing address
920 HIGHWAY 287 N, STE. 308, MANSFIELD, TX 76063-2627
(817) 473-7197
(817) 473-7198
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
L7520
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
180563202
—
TX
Enumeration date
03/29/2007
Last updated
04/01/2008
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