MEDICARE: DR. TRI MINH NGUYEN DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	24943	TX

General Provider Information

NPI Number	:	1063745099
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TRI MINH NGUYEN DDS

Provider Business Mailing Address
First Line	:	3950 N FRY RD STE 600
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77449-6743
Country	:	US
Telephone Number	:	281-578-3300
Fax Number	:	832-565-8213

Provider Business Practice Location Address
First Line	:	3950 N FRY RD STE 600
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77449-6743
Country	:	US
Telephone Number	:	281-578-3300
Fax Number	:	832-565-8213

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/09/2009
Last Update Date	:	09/09/2009

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