Provider Demographics
NPI:1164678264
Name:TONYA TRUONG COOLEY DO, PA
Entity type:Organization
Organization Name:TONYA TRUONG COOLEY DO, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:TONYA
Authorized Official - Middle Name:TRUONG
Authorized Official - Last Name:COOLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:972-889-8353
Mailing Address - Street 1:9780 WALNUT ST
Mailing Address - Street 2:SUITE 150
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-2389
Mailing Address - Country:US
Mailing Address - Phone:972-889-8353
Mailing Address - Fax:972-889-8355
Practice Address - Street 1:9780 WALNUT ST
Practice Address - Street 2:SUITE 150
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-2389
Practice Address - Country:US
Practice Address - Phone:972-889-8353
Practice Address - Fax:972-889-8355
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-08
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK0692261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0038ATMedicare PIN