MEDICARE: DR. PETER TUAN NGUYEN M.D.

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	M0512	TX
2	207RN0300X	Nephrology Physician	M0512	TX

General Provider Information

NPI Number	:	1700974508
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PETER TUAN NGUYEN M.D.

Provider Business Mailing Address
First Line	:	6560 FANNIN ST STE 2206
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-2726
Country	:	US
Telephone Number	:	713-790-4615
Fax Number	:	713-790-5878

Provider Business Practice Location Address
First Line	:	6560 FANNIN ST STE 2206
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-2726
Country	:	US
Telephone Number	:	713-790-4615
Fax Number	:	713-790-5878

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

Provider Enumeration Date	:	10/10/2006
Last Update Date	:	06/23/2011

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