Provider Demographics
NPI:1629040753
Name:HOANG, CUC (CRNA)
Entity type:Individual
Prefix:
First Name:CUC
Middle Name:
Last Name:HOANG
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 THROCKMORTON ST
Mailing Address - Street 2:#2002
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76102-3708
Mailing Address - Country:US
Mailing Address - Phone:214-923-3508
Mailing Address - Fax:
Practice Address - Street 1:500 THROCKMORTON ST
Practice Address - Street 2:#2002
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76102-3708
Practice Address - Country:US
Practice Address - Phone:214-923-3508
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-02
Last Update Date:2010-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX638585367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX89782UOtherBCBSTX
TX157192906Medicaid
TX8B6903Medicare ID - Type Unspecified
TX157192906Medicaid