Long Cuu Cong Ta, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

744105 Issued in TX

Practice address

4500 S Lancaster Rd
Dallas, TX 75216-7167

Phone

(512) 466-0836

NPI assigned

Jan 14, 2013

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1358121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358121600000",
    "number": "1922345727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1413 VANDERBILT ST E APT 707",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761204942",
            "telephone_number": "512-466-0836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 S LANCASTER RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752167167",
            "telephone_number": "512-466-0836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TA",
        "first_name": "LONG",
        "middle_name": "CUU CONG",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-01-14",
        "last_updated": "2013-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "744105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• T.E.a.M.
• T.S. Recuperative Care of North Texas
• T&L Medical Supply Incorporated
• T2 Laboratories, LLC
• T2 Orthopedics Distribution LLC
• Stevens T Ta, D.D.S.
• Sean Maximillian Taasan
• Mohammad Taba
• Benjamin David Tabaria, CRNA
• Subhan Tabba, MD, MBA

• Certified Registered Nurse Anesthetist in Dallas, TX
• Providers in Dallas, TX by specialty
• Certified Registered Nurse Anesthetist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.