Provider Demographics
NPI:1023637550
Name:TRUONG, KHANH THOAI (DO)
Entity type:Individual
Prefix:
First Name:KHANH
Middle Name:THOAI
Last Name:TRUONG
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6513 CHASE OAKS BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75023-2309
Mailing Address - Country:US
Mailing Address - Phone:972-509-0752
Mailing Address - Fax:972-517-8770
Practice Address - Street 1:6513 CHASE OAKS BLVD STE A
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75023-2309
Practice Address - Country:US
Practice Address - Phone:972-509-0752
Practice Address - Fax:972-517-8770
Is Sole Proprietor?:No
Enumeration Date:2020-04-14
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT9807207QS1201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS1201XAllopathic & Osteopathic PhysiciansFamily MedicineSleep Medicine