MEDICARE: VICTORIA NGUYEN SLPA

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	246Q00000X	Pathology Specialist/Technologist	37767	TX

General Provider Information

NPI Number	:	1457854937
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICTORIA NGUYEN SLPA

Provider Business Mailing Address
First Line	:	531 HAWTHORNE DR
Second Line	:
City	:	MURPHY
State	:	TX
Zip	:	75094-3545
Country	:	US
Telephone Number	:	469-867-6023
Fax Number	:

Provider Business Practice Location Address
First Line	:	1201 N WATSON RD STE 220
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76006-6120
Country	:	US
Telephone Number	:	817-422-9203
Fax Number	:

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

Provider Enumeration Date	:	03/12/2018
Last Update Date	:	03/12/2018

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Directions to “ VICTORIA NGUYEN SLPA” Practice Location

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