MEDICARE: MRS. MONIQUE NGUYEN M.A.

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	231H00000X	Audiologist	80022	TX

General Provider Information

NPI Number	:	1134307333
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MONIQUE NGUYEN M.A.

Provider Business Mailing Address
First Line	:	1848 NORWOOD PLZ
Second Line	:	STE 101
City	:	HURST
State	:	TX
Zip	:	76054-3720
Country	:	US
Telephone Number	:	800-675-5485
Fax Number	:

Provider Business Practice Location Address
First Line	:	1848 NORWOOD PLZ
Second Line	:	STE 101
City	:	HURST
State	:	TX
Zip	:	76054-3720
Country	:	US
Telephone Number	:	800-675-5485
Fax Number	:

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

Provider Enumeration Date	:	02/11/2008
Last Update Date	:	02/11/2008

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