Individual
KHANH HA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D
Contact information
Practice address
1300 S CAGE BLVD STE K, PHARR, TX 78577-6352
(956) 413-7540
Mailing address
1300 S CAGE BLVD STE K, PHARR, TX 78577-6352
(956) 413-7540
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
35753
TX
1223G0001X
General Practice Dentistry
2017014938
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
NA
TX
Enumeration date
02/25/2016
Last updated
03/09/2021
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