MEDICARE: BAOLIEN NGUYEN TU 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	174400000X	Specialist	19687	OK

General Provider Information

NPI Number	:	1831130913
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BAOLIEN NGUYEN TU M.D.

Provider Business Mailing Address
First Line	:	9711 NAWASSA DR
Second Line	:
City	:	MIDWEST CITY
State	:	OK
Zip	:	73130-4522
Country	:	US
Telephone Number	:	405-642-6368
Fax Number	:

Provider Business Practice Location Address
First Line	:	9711 NAWASSA DR
Second Line	:
City	:	MIDWEST CITY
State	:	OK
Zip	:	73130-4522
Country	:	US
Telephone Number	:	405-642-6368
Fax Number	:

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

Provider Enumeration Date	:	06/09/2006
Last Update Date	:	11/21/2025

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