Individual
LONG TRUONG HOANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
855 MONTGOMERY ST, FORT WORTH, TX 76107
(817) 735-7622
Mailing address
855 MONTGOMERY ST, FORT WORTH, TX 76107-2553
(817) 735-7622
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
K4917
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100016551
RAILROAD MEDICARE
TX
05
—
152059501
—
TX
01
—
8A5417
BCBS
TX
Enumeration date
04/11/2006
Last updated
08/23/2019
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