DR. KHOMTHORN P CUNVONG DO
NPI 1396361580
Student in an Organized Health Care Education/Training Program in Arlington, TX

Active since June 23, 2020PECOS EnrolledAccepts Medicare Assignment
3301 MATLOCK RD, ARLINGTON, TX 76015(682) 509-6200 Get Directions Write a Review

NPPES record last updated: June 23, 2020. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Dr. Khomthorn P Cunvong Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. KHOMTHORN P CUNVONG DO (NPI 1396361580) is an individual student in an organized health care education/training program in Arlington, Texas and active in the NPI registry since June 2020. He is enrolled in Medicare PECOS and is a graduate of Other (2020).

NPPES Registry Identity

NPI1396361580
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameDR. KHOMTHORN P CUNVONGCredential: DO
Location Address3301 MATLOCK RDArlington, TX 76015-2908
Mailing Address3301 Matlock RdArlington, TX 76015-2908 · (682) 509-6200
Sole ProprietorNo
Medical School CMSOtherGraduated 2020
Enumeration DateJune 23, 2020
NPPES CertifiedJune 23, 2020
NPI 1396361580 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Taxonomy Code390200000X
Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

3301 MATLOCK RD, Arlington, TX 76015

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dr. Khomthorn P Cunvong Do is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9133567068
PECOS Enrollment IDI20240410003168
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Emergency Medicine
3301 MATLOCK RD
ARLINGTON, TX 76015
Emergency Medicine
3301 MATLOCK RD
ARLINGTON, TX 76015
Emergency Medicine
3301 MATLOCK RD
ARLINGTON, TX 76015
Emergency Medicine
3301 MATLOCK RD
ARLINGTON, TX 76015
Emergency Medicine
3301 MATLOCK RD
ARLINGTON, TX 76015
Emergency Medicine
3301 MATLOCK RD
ARLINGTON, TX 76015
Emergency Medicine
3301 MATLOCK RD
ARLINGTON, TX 76015
Emergency Medicine
3301 MATLOCK RD
ARLINGTON, TX 76015

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1396361580, enumerated as an "individual" on June 23, 2020.

The provider is located at 3301 MATLOCK RD ARLINGTON, TX 76015 and the phone number is (682) 509-6200.

Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.