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Individual

BOUAPHANE HONGKEO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
1935 MEDICAL DISTRICT DR, DALLAS, TX 75235-7701
(214) 456-6660
(214) 456-6696
Mailing address
2300 MESA OAK TRL, PLANO, TX 75025-4721
(214) 280-9267

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA04770
TX

Other

Enumeration date
11/05/2009
Last updated
11/05/2009
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