MEDICARE: DR. GIAM NGUYEN D.O.

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	207R00000X	Internal Medicine Physician	L9394	TX

General Provider Information

NPI Number	:	1356351449
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GIAM NGUYEN D.O.

Provider Business Mailing Address
First Line	:	2110 JEFFERSON ST
Second Line	:	SUITE 107
City	:	HOUSTON
State	:	TX
Zip	:	77003-5100
Country	:	US
Telephone Number	:	713-224-5887
Fax Number	:	713-224-5388

Provider Business Practice Location Address
First Line	:	2110 JEFFERSON ST
Second Line	:	SUITE 107
City	:	HOUSTON
State	:	TX
Zip	:	77003-5100
Country	:	US
Telephone Number	:	713-224-5887
Fax Number	:	713-224-5388

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

Provider Enumeration Date	:	08/09/2006
Last Update Date	:	01/20/2009

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