MEDICARE: DUNG KHANH NGUYEN

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	251E00000X	Home Health Agency	014440	TX

General Provider Information

NPI Number	:	1225386279
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DUNG KHANH NGUYEN

Provider Business Mailing Address
First Line	:	8052 BOONE RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77072-4925
Country	:	US
Telephone Number	:	713-294-1733
Fax Number	:	281-933-8779

Provider Business Practice Location Address
First Line	:	8052 BOONE RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77072-4925
Country	:	US
Telephone Number	:	713-294-1733
Fax Number	:	281-933-8779

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

Provider Enumeration Date	:	08/23/2012
Last Update Date	:	08/23/2012

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