Healthcare Provider Details

I. General information

NPI: 1932887767
Provider Name (Legal Business Name): TRANG NGUYEN MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2023
Last Update Date: 02/09/2024
Certification Date: 02/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13402 E 86TH ST N
OWASSO OK
74055-8767
US

IV. Provider business mailing address

6412 E 84TH ST
TULSA OK
74137
US

V. Phone/Fax

Practice location:
  • Phone: 918-401-3100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. TRANG HUYEN NGUYEN
Title or Position: OWNER
Credential: MD
Phone: 918-850-4741