Healthcare Provider Details

I. General information

NPI: 1821843897
Provider Name (Legal Business Name): NEURORADIOLOGY & PAIN SOLUTIONS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2024
Last Update Date: 09/03/2025
Certification Date: 09/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 N LINCOLN BLVD STE 4000
OKLAHOMA CITY OK
73104-3252
US

IV. Provider business mailing address

2716 OPEN RANGE RD
EDMOND OK
73034-3484
US

V. Phone/Fax

Practice location:
  • Phone: 405-271-4912
  • Fax: 405-271-3091
Mailing address:
  • Phone: 202-258-1455
  • Fax: 405-643-4682

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DAN TD NGUYEN
Title or Position: OWNER / PROVIDER
Credential: MD
Phone: 202-258-1455