MEDICARE: MATTIE NGUYEN DC

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	111N00000X	Chiropractor	7875	TX

General Provider Information

NPI Number	:	1497861975
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTIE NGUYEN DC

Provider Business Mailing Address
First Line	:	6633 HILLCROFT ST
Second Line	:	SUITE 109
City	:	HOUSTON
State	:	TX
Zip	:	77081-4887
Country	:	US
Telephone Number	:	713-776-0185
Fax Number	:	713-550-1409

Provider Business Practice Location Address
First Line	:	6633 HILLCROFT ST
Second Line	:	SUITE 109
City	:	HOUSTON
State	:	TX
Zip	:	77081-4887
Country	:	US
Telephone Number	:	713-776-0185
Fax Number	:	713-550-1409

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

Provider Enumeration Date	:	08/21/2006
Last Update Date	:	07/08/2007

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Directions to “ MATTIE NGUYEN DC” Practice Location

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