Provider Demographics
NPI:1730246208
Name:OO, MAUNG MAUNG (MD)
Entity type:Individual
Prefix:DR
First Name:MAUNG
Middle Name:MAUNG
Last Name:OO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:721 CLINIC DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75701-2043
Mailing Address - Country:US
Mailing Address - Phone:903-592-6152
Mailing Address - Fax:903-526-0629
Practice Address - Street 1:115 MEDICAL CIR
Practice Address - Street 2:SUITE 106
Practice Address - City:ATHENS
Practice Address - State:TX
Practice Address - Zip Code:75751-9004
Practice Address - Country:US
Practice Address - Phone:903-675-1322
Practice Address - Fax:903-675-6743
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2016-11-17
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Provider Licenses
StateLicense IDTaxonomies
TXL0890207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX045604803Medicaid
TXG99801Medicare UPIN
TX045604803Medicaid